Today's pregnant women are ditching childbirth education courses in droves. Is this smart?
The Evolution Of Childbirth Ed
"Prepared childbirth" was inspired by British obstetrician Grantly Dick-Read, whose 1944 book, Childbirth Without Fear, advocated education and relaxation to overcome the "fear-tension-pain syndrome" of labor. French obstetrician Fernand Lamaze, whose strategies for "painless childbirth" included focused breathing, was hugely influential in the U.S.; by the '70s, "Lamaze" had become shorthand for such classes.
But as medical intervention during labor has become more commonplace, labor prep has morphed, especially in generic, hospital-based classes. Teachers employed by hospitals often cut back on instructing women in breathing and other self-help coping techniques, replacing them with a rundown of the institution's procedures and a tour of the delivery room. Cara Drinan of Alexandria, Va., took a one-day, 9-to-5 course offered by a hospital but didn't think it was useful. "The teacher, a nurse, walked us through the stages of labor and showed videos of different kinds of births," she says. "She tried to teach breathing, but the class was so abbreviated. It was a lot to cover in a short time."
Knowledge Is Power
Ironically, the more birth becomes medicalized, the more important it is to take a good class. "Everyone thinks they've prepared well, and the doctor or midwife will give you a song and dance about having the delivery you want," says Dunham, who was induced with her first baby. "But labor is notoriously variable, and situations arise that require decisions." That's where you reap the dividends of having had a teacher who explained each possible intervention and showed you how to be your own advocate.
"Most women would attend classes if they knew labor preparation is not about teaching women to 'breathe,'" Crenshaw maintains. "It's about building confidence, exploring birth options and making informed decisions that contribute to a satisfying labor and delivery." For example, surveys have found that most women who receive epidurals are not properly informed of the risks, she says. "It's easy to choose something if you think it will decrease pain but has no consequences," Crenshaw explains.
While there's no perfect labor-prep class, it's worth looking for one that answers your needs and suits your personality (see "Labor-Prep Schools," next page). If you're highly anxious, you might consider HypnoBirthing. If you're interested in learning as much as you can about the birthing process, you might prefer to study with a Lamaze or a Bradley teacher. Or, like Cara Drinan, you may want to hedge your bets. "I didn't put all my chips on the class," she says. "I'd already hired a doula."