The evidence is clear that the person with the greatest influence on birth
outcome is the care giver in charge at the time - it is their attitudes,
practises, philosophy, habits and routines that will shape the birth
experience, regardless of what the woman may say or want.
Given this fact, the single most important decision that a woman makes in
her pregnancy, in terms of getting the kind of birth she wants, is the
choice of care giver.
Most prenatal classes start towards the end of pregnancy (there is no
evidence that this is the "best time" - this scheduling is just another
"habit") and if childbirth education programs were available to all women
in the early part of their pregnancy, the issue of choice of care giver
could be aired and options discussed. At that time, the difference between
the various models of care could be highlighted, in plenty of time for
parents to decide what they want and to shop around.
The potential of early pregnancy programs has never been fully exploited,
yet it would be a great way of promoting midwifery and enlightening parents
about the health care system. To ensure good attendance, it is important
not to provide the program as an "extra" that is optional, but the allocate
the dates within the regular program. Parents can be told when they book
into hospital that their first class will be very soon and that later
classes will follow.
Something for all educators to think about?
Regards,
Andrea
At 03:47 PM 29/05/2005, you wrote:
I agree wholeheartedly with Nicole's post. It is very hard to give a
balanced view when one knows that we are working within an obstetric model
and the intervention rates that come with it.
We try hard to instill the ideal of natural birth but are aware of the
risk of setting the women up for feelings of failure if we emphasise this
and ignore the 'other' stuff.
Even women who are booked for elective C/S come to classes and we have a
duty to inform them too.
Also inherent is the time factor - how much can you reasonably get across
within the time allocated to classes.
Sue
"The only thing necessary for the triumph of evil is for good men to do
nothing"
Edmund Burke
----- Original Message -----
From: <mailto:[EMAIL PROTECTED]>Nicole Carver
To: <mailto:[email protected]>[email protected]
Sent: Friday, May 27, 2005 3:08 PM
Subject: RE: [ozmidwifery] Childbirth Education classes
Hi All,
I have worked as a child birth educator in a hospital which has fairly
comparable intervention rates to other public hospitals in Victoria.
However, to me we have a lot of unnecessary intervention, particularly
induction of labour, and the cascade of intervention that then sometimes
occurs.
The quandary for a CBE in this environment is: do you educate for the
ideal, or the reality of the environment that the women will birth in? If
you tell them the reality, you would sit them in a circle of ten women and
say only four of you are going to have a birth without intervention. What
do you want to know to help you cope with a birth with intervention? Or do
you teach them all natural, and know that many of them are going to be
devastated by the reality of the actual birth that happens? Their partners
too. It's a tough one. I struggled with it, because I also worked in the
system. The women who advocate for themselves, or the midwives who do so,
have to be very strong. Ultimately the power rests with the obstetricians.
There are no alternative employers of midwives in my town. When teaching
CBE classes I compromised, and taught about both. And ensured that the
realities of the different interventions were discussed, so that women did
not think that C/S is comparable to vaginal birth and so on.
I can imagine a CBE working in the private system would be faced with even
higher intervention rates. The other problem is having obstetricians
coming after you for teaching THEIR women about things they would prefer
they did not know.
I think changes need to occur across the whole system, starting with
midwife led care. It would be great if midwives could do the education for
the women for whom they would be providing birthing care. The intervention
rates would plummet, and education about intervention in birth could be
made optional, and therefore available for those who want to know
absolutely everything, or for those for whom intervention may be more
likely.Otherwise a midwife could set the scene for the ways she has learnt
to practice in birthing to maximise women's chance of a positive and
optimal birth experience.
I do think child birth education today is a reflection of our system. I
also think CBE's try very hard to do their best for women and their
support people. They are stuck in the middle of a far from ideal situation.
Nicole Carver.
[Nicole Carver] -----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Dean & Jo
Sent: Friday, May 27, 2005 2:43 PM
To: [email protected]
Subject: RE: [ozmidwifery] Childbirth Education classes
I feel there needs to be legislation to bring cbe OUT of the institutions
to the community. In SA we are sooooo proud of our state wide Perinatal
guidelines, there is probable cause to push the need for education to be
statewide also. We need the government to push safe and happy birthing by
promoting education that impacts these things. And then the little
piggies can fly
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Diane Gardner
Sent: Friday, May 27, 2005 1:57 PM
To: [email protected]
Subject: [ozmidwifery] Childbirth Education classes
Wow am I steamed! I've just had a woman ring me in an absolute mess. She
attended the Prenatal classes run by St Vincents Private just recently and
and is scared out of her wits. She said she had been so excited and
looking forward to birthing her baby until she attended the classes. She
said they fed in negative, pain, complications and drugs!
What is going on here? We wonder why women go into labour in a hospital
screaming and begging for drugs. Just what sort of programming are these
classes installing into women and taking away their ability to trust their
bodies for birth. How long do we have to put up with this and how much
worse is it going to get before the hospital Boards GET it or is the money
rewards for doing all this more important than birth.
Sorry to vent here SO loudly but I'm getting so fed up with this same old
story. Where does one have to start to have these classes brought back to
the real world and some sensible and simple tools for birth! Sheesh
Breathing and counting to 10.......20.........30 grrrrrrrrrrrrrrrrrrr
ahhhhhhhhhhhhhhh!!!
Diane
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Andrea Robertson
Birth International * ACE Graphics * Associates in Childbirth Education
e-mail: [EMAIL PROTECTED]
web: www.birthinternational.com
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