Choose a Class

CHOOSING A PRENATAL CLASS:

THE WHAT, WHO, WHERE, WHEN, HOW AND WHY

By Krysal Hoople RN, BScN, IBCLC

Previously published in Birth Issues, Fall 2011

Helga Himer Photography

Helga Himer Photography

Congratulations on your pregnancy! This is a very exciting time that comes with an overwhelming amount of preparation. The only thing more overwhelming than naming your baby and finding the safest car seat is choosing a childbirth education course that is right for you! As a Registered Nurse, Lactation Consultant and mom, I have used my experience to compile a list of what to look for and expect from a prenatal course.

1. What: Prenatal philosophy

While all childbirth classes aim to educate participants, their philosophies vary considerably. Familiarizing yourself with available options can help you choose the class that is right for you. Some of the more widely know approaches to childbirth include:

HypnoBirthing: This method teaches mothers that if you remove fear and tension, severe pain does not have to be part of labour. Intense relaxation will enhance natural birthing instincts that lead to a calm and serene birth experience. The curriculum also teaches women how to experience a feeling similar to daydreaming, while remaining controlled and happy during labour and birth. For more information: www.hypnobirthing.com

Birthing From Within: It presents childbirth as a rite of passage for both parents and baby, rather than as a medical procedure. While facilitators will discuss pain medication, they encourage expectant mothers to trust in their bodies’ capacity to birth naturally and to reinterpret pain as something to be expected, but not feared. For more information: www.birthingfromwithin.com

The Bradley Method: It stresses the importance of a well-prepared, supportive birthing coach. Couples learn the birthing and coaching techniques needed for each stage of normal labour as well as skills for coping with unexpected complications. For more information: www.bradleybirth.com

Lamaze: It uses a contemporary curriculum that supports birth as normal, natural, and healthy and empowers expectant women and their partners to make informed decisions. For more information: www.lamaze.org

International Childbirth Education Association (ICEA): Family-centered maternity care (FCMC) is ICEA’s primary goal and the basis of ICEA philosophy. In 1986 ICEA adopted the McMaster University definition of FCMC: “The birth of a baby represents, as well, the birth of a family. The woman giving birth and the persons significant and close to her are forming a new relationship, with new responsibilities to each other, to the baby, and to society as a whole. Family-centered reproductive care may be defined as care which recognizes the importance of these new relationships and responsibilities, and which has as its goal the best possible health outcome for all members of the family, both as individuals and as a group. Family-centered care consists of an attitude rather than a protocol. It recognizes a vital life event rather than a medical procedure. It appreciates the importance of that event to the woman and to the persons who are important to her. It respects the woman’s individuality and her sense of autonomy. It realizes that the decisions she may make are based on many influences of which the expertise of the professional is only one. It requires that all relevant information be made available to the woman to help her achieve her own goals, and that she be guided but not directed by professionals she has chosen to share the responsibility for her care.”1 For more information: www.icea.org

There are many independent educators or classes which aren’t guided by any of these better known philosophies: midwives who offer it as part of their course of care, doulas who offer classes, registered nurses with Public Health and maternity experience, hospital based courses or classes especially for teens, parents expecting multiples, etc.2

A good prenatal class should, at the very least, cover:

• the environment of an undisturbed birth
• how knowing ones anatomy and physiology helps childbirth
• the normal progress of labour and birth
• the signs of labour and when to call your doctor or midwife
• comfort techniques
• how to make informed choices and advocate for oneself
• the pros and cons of all childbirth interventions, drugs, and protocols
• how a support person can help you during labour
• early postpartum period
• breastfeeding
• car seat and safety

2.Where: Choosing an instructor and a location

Once you have selected a method or philosophy that you and your partner want to follow, find an instructor in whom you have confidence. The best method of finding a good instructor is checking with other dads and moms who have been through the class. Childbirth educators vary enormously in what they offer and in their beliefs. If you are open to using pain medication (i.e. an epidural or other options) steer clear of instructors who discourage their use. Similarly, if you are determined to have a natural (drug free) birth, find a class that offers a wide variety of relaxation and pain management techniques, and leaves you well versed in common childbirth interventions and their pros and cons.

Talk to the instructor either in person or on the phone. This will give you the opportunity to interview her. Find out her level of experience and certification. Make sure she provides the right learning environment for you.

The location of the class can tell you what type of class it will be. A class located in a hospital, a public health centre or a doctor’s office will generally follow a more medical model, whereas a class taught by an independent instructor held in a non-medical location may be a more consumer-oriented service.

Consider looking for independent classes held outside the hospital and health centres. Independently taught classes tend to offer a wider range of information whereas hospital classes tend to teach how to be prepared for giving birth in their facility.

3. When: Sign up early!

Don’t wait until the last, hectic weeks of your pregnancy to take a class. The ideal time to attend a course is during your second trimester. This way, you will finish the course even if you deliver early or experience unforeseen developments Completing classes early allows you more time to practice the class exercises and supplement what you have learned with additional childbirth books, lectures, or workshops.

4. Who: Private or classroom?

Many independent childbirth educators offer expectant couple’s private, one-on-one instruction. Private instruction allows for more flexibility and individualization. Classes are arranged around your schedule and greatly benefit those who are not able to attend the weekly group classes. Private classes allow you to ask personal questions that you otherwise may not ask in a group setting. Some private classes are taught in the comfort of your home. This especially benefits those women on bed rest. Private classes will cost a little more, but it may be worth the difference. Having other people in the class gives you the chance to learn from their observations and experiences. Frequently, women who attend childbirth classes together go on to form friendships, support networks, and playgroups that ease some of the isolation associated with being a new mom.

An ideal childbirth class has between 3-10 couples. You need enough people to start a good discussion, but not so many that you are just a number to your teacher.

5. How: Time and financial commitment

A session consisting of four or more classes, each lasting somewhere between two to four hours is ideal. This allows you the time to get your questions answered and learn more information on each topic. Plus, meeting with the same group over several weeks provides you with a great support network. Taking an intensive, one-day course (those usually last eight hours) is better than nothing, but can be exhausting, overwhelming and deprives you of many of the benefits of a more in-depth class.

Prenatal classes range in price from $100 to $250. The cost is usually dependent on the educators’ experience and the length of the class. Feeling prepared and confident for one of the biggest days of your life is money well spent!

6. Why: Knowledge is power

Only 30% of Canadian women attend a prenatal class3.  How are the rest educating themselves about childbirth? Are they relying on 10 minute appointments with their doctors to provide them with an education? Where are they getting prenatal information from (the television or the Internet)? Every expectant mom and dad deserves to be an informed participant in the most important event of their life: becoming a parent. Lack of knowledge is disempowering. Parents have a right and even a responsibility to make truly informed choices (not just give partially informed consent) throughout their prenatal care and birth. The right childbirth class can educate and prepare you for this life-changing experience! Spend the time to find the class that will prepare you and give you the confidence to allow your body to do what it naturally knows…birthing!

Krystal Hoople is the mother of three amazing kids. Krystal specializes in Labour and Delivery, Breastfeeding Support and Education. Krystal has her degree in Nursing and is a Certified Lactation Consultant. Krystal’s experience in the medical profession and with holistic therapies provides her the opportunity to offer the best of both beliefs.

Notes:
1. International Childbirth Education Association, Philosophy statement, www.icea.org/content/mission (accessed May 31, 2011).
2. See Birth Issues magazine for a listing of prenatal classes currently offered in the Edmonton area.
3. Beverley Chalmers and Dawn Kingston, Prenatal Classes, Public Health Agency of Canada. In What Mothers Say: The Canadian Maternity Experiences Survey. Ottawa, 2009, 56-59.