Activities for Online Birth Classes

In the past year, so many of us have moved our classes online. We may continue to be online through coronavirus and beyond, as some instructors are considering continuing to offer online classes from now on, in addition to in-person. We’ve discovered that online classes can help make our classes more accessible to people from a broader geographic area, to people with limited transportation, folks who don’t want to deal with commuting to and parking at a class site, folks with disabilities, parents on bed rest, and more.

How do we make our online classes as engaging and memorable as possible? Here are lots of ideas for interactive birth class activities. My examples will go in order from pregnancy topics through the stages of labor and into postpartum and baby care. Most of the techniques can be adapted to many more topics than I address in my example.

Healthy Pregnancy

Due to my state’s Medicaid requirements, we have to cover several specific topics, including substances (alcohol, drugs, tobacco), healthy nutrition and food safety, exercise, sexuality and more. To address these topics, you could create an online Jeopardy game, or create a quiz in Kahoot to use in class, or use Zoom polls to quiz them during class. Or you could use Google Forms to create a quiz to send to the students as “homework.” You could use these wellness cards for ideas for questions and answers to include. You could adapt a grab bag activity by having a slide show with pictures of items and asking them to talk about them.

Anatomy Pictionary

Sharon Muza has a great icebreaker activity where she has students draw anatomy. You can easily adapt this to online classes by splitting students up into breakout rooms, have them use the Zoom whiteboard to create drawings, then screen capture those and return to the main room to share.

Jamboard Signs of Labor

This is an interactive bulletin board type activity, where there are post-its listing symptoms that labor may be starting. Students sort them into possible, probable, and positive signs of labor. Find it here, and make a copy for your use: https://jamboard.google.com/d/1a_zy4wqWA6koO0bfuQ_6aAbZIWjekdMjinHLaO_mjdo/edit?usp=sharing

On a Zoom call, the way you would use this is: paste the link into chat. Everyone goes to the link and they can all manipulate it together, and you can talk them through it. (Learn more about using outside apps with Zoom.) If you’re meeting in-person, I’ve got an old school version of this activity where you print the cards and they sort them.

Comfort Techniques Chat Storm

Tell them “I’m going to ask you all to type some ideas into chat… First, I want you to think about when you’re sick – what helps you to feel better?” They start typing, then you can prompt them more… “It may help you to think – when you were a kid, what did your parent do to help you feel better? Or what did you wish they had done that you think would have helped.” As all the ideas pour in over chat, you can read some out loud, affirm them, comment on how these might be used in labor. Then do another storm for “what helps you to relax?” (more questions)

Comfort Tools Scavenger Hunt

Either during your presentation on comfort techniques for early labor, or in a discussion of “what to pack for the hospital”, send students off to find something in their house that helps when they’re in pain, or sick, or feeling worried. Have them do show and tell, and talk about how you could use those in labor.

Virtual Background for Hospital Routines

When you discuss arriving at the hospital, you can use a photo of triage room as your virtual background. (Learn how to use virtual backgrounds in Zoom.) When you discuss moving to the hospital room, change your background to reflect that.

Word Cloud – what will labor be like?

During in-person classes, I’ve used a worksheet where people can circle words that represent what they think birth will be like (words like: messy, excruciating, beautiful, long…). Then they discuss – if your birth is like that, what support will you need? (Or if you’re providing labor support, and the birth is like that, how will you best support the laboring person?) In a virtual class, you could do this as a word cloud, where all the students add their words, and you’d see common themes arise, as words that multiple people type are shown bigger than those only added by one. I have directions on how to do a word cloud in mentimeter here: https://janelledurham.com/guide…/use-other-apps-with-zoom/

Jigsaw Puzzle Stages of Labor

Take your favorite poster / infographic of the Stages of Labor, and convert it to a jigsaw puzzle, as Mallory Emerson describes here: https://www.lamaze.org/Connecting-the-Dots/Post/series-brilliant-activities-for-birth-educators-solve-the-puzzle-of-virtual-teaching. For copyright purposes, you should only use images that you otherwise have the rights to use in your classroom. You can purchase a variety of images. I like the Road Map of Labor from Childbirth Graphics, but there’s also good stuff available through Plumtree, Better Birth, and Birthing with Guinever. (Find links to those products in my post on Where to Find AV Aids.)

You could either use this as homework – send students a link to do at home after class, or you could do it collaboratively during an online class – maybe as a warm-up before starting class or as a breaktime activity. It’s low key, interactive, and good for the visual and kinesthetic learners to review labor stages by interacting with the images.

Continuum Exercises

In a classroom, I have used a continuum exercise for something like: “If you have TONS of experience taking care of lots of newborn babies, go to that end of the room. If you’ve never held a baby under 6 months old, go to that end. The rest of you array yourself somewhere on that continuum.” It’s helpful to me to see the range of knowledge and helpful to them to see that they’re not the only ones… I have never done this for topics that I feel like people can be judgmental about… “oh, I knew she was one of those people.” But online you can do this anonymously. Have a slide showing a continuum like the pain medication preference scale, and you can have them annotate it to mark where they are. (You could also do this a poll or using another – rate on a scale of 1 – 10 type tool.)

Thumbs Up / Thumbs Down Reactions

They can use Zoom reactions to vote. Could be used for something like: “is this normal or is this a warning sign?” Or “is it time to go to the birthplace?” Or “True or False.”

Show and Tell

Sharon Muza suggests having students bring to class session: something they’ll want nearby when they’re nursing, or something they will use for newborn care. Learn more.

More Ideas / Training

For more general ideas you could adapt to perinatal topics, check out my Zoom Guide for more ideas on Demo Physical Activities on Zoom, Games and Interaction on Zoom, Use Other Apps with Zoom, Using Zoom on Facebook Portal, and more.

If you’d like to learn more about exactly how to use virtual teaching techniques in the birth class setting, I highly recommend the Creative and Confident classes offered by Sharon Muza, FACCE and Mallory Emerson, LCCE.

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AV Aids for Birth Classes – 3-D Models

In separate posts, I cover where to find images (posters, PowerPoints, and illustrations) and videos. This post is focused on 3-D models: pelvis, breast, fetal dolls, placentas, and so on.

Note, all prices and links are current as of February 2021, and all may change (especially the Etsy items.)

Childbirth Graphics is the most comprehensive source. They’ve got all the basics: pelvises, fetal dolls, placentas, and breasts. And a whole lot more: cervix models, milk fat comparisons, pregnancy bellies… Durable and high quality. Sample prices: set of pelvis, doll, placenta, perineum is $256; pelvis $74 or $133; newborn doll $69; breast model $87.

Cascade Health Care Products has a number of products… they appear to all be Childbirth Graphics items that they are selling. Some of their prices are higher than Childbirth Graphics and some are lower, so it’s worth comparing. Set $279; doll $64; breast $97.

Birthing, Bonding, and Breastfeeding. Has rubber breast models ($20), crocheted breasts, and a breast model scarf. They say “The rubber silicone-filled breast forms a seal to allow for demonstration of flange fitting and nipple positioning. Breast reacts to pump and simulates what pumping should look like when the nipple placement is correct.”

Anatomy Warehouse. They have multiple pelvis styles and a placenta. They also have lots of anatomical training models that are not items you would use in a class. Pelvises range from $41 – $70.

Brilliant Activities for Birth Educators. This is not a site that sells AV aids… it’s a blog that tells you how to make your own! Lots of fun ideas for interactive activities.

Crochet or Knit Your AV’s: this post has links to patterns.

DIY Pelvis. How to make a pelvis model from 2 file folders!

Amazon

You can buy models on Amazon. They sell the Childbirth Graphics set, but it’s $275, and you can get it for $256 direct from CG. They have multiple inexpensive pelvises that claim to be life-size and flexible, but the reviews often say they are not life-size, not flexible and not that well-made. (But, they do have one that’s just $39, so maybe that’s a fair compromise?) They have this mini doll and pelvis for $39 or the doll, pelvis and placenta for $69, but the quality looks poor. (And they also have identical products that are sold under many brand names for a wide variety of prices, which is typical of low quality imports.) I think you would be better served by saving up money for one of the professional quality models from Childbirth Graphics (which last for decades!) or picking one of the Etsy items below.

(Note: the Amazon links are affiliate links – if you purchase anything on Amazon after clicking on one, I do get a small referral fee.)

Etsy Shops

Edy’s Wonderland. Set of pelvis, uterus, baby, placenta $167 (can buy pieces separately.) Miniature set of baby, placenta, uterus, beanie, diaper $56. Breast $17.

Wicked Stitches. The full set shown of sperm, uterus, placenta, baby, breast, belly balls, and baby poop / diaper is $131. All sold separately. Sample cost – breast $18.

Mother Hen Doula – Felt Pelvis for $6. Knitted breast $8, placenta $9, uterus $17.

Viva Doula. Non-pregnant uterus with detachable vagina and vulva; full-term uterus, placenta and sac; breast $234 for set; pieces sold separately. Sample cost breast $53. Also has miniature sets, dolls, knit penis, weighted doll $197.

Birth Matters NW. Weighted Dolls. $50

Mam Amour Dolls. Breast model and breastfeeding baby doll, $221. VBAC Mama Doll $234.

Namsis Craft. Breast and latch $25; placenta $110; doll $80, pelvis $60, uterus.

Milk Mama Milk. Placenta, baby, uterus $119; breast and latch puppet $34, diaper with poop $13, belly balls $12.

Your Birth. Doll $20. Cesarean birth apron $65.

Bebek liked ishop. Placenta, non-pregnant uterus, 4 breasts for $170. Placenta $48.

Soul Mama Crochet. Breast $22, breast and placenta $44

Hazel Creates Threads. Cloth pelvis, uterus and amniotic sac, crochet placenta and breast $133

Clover Care Doula Services. Uterus, placenta and membranes $108.

More ideas?

If you know of other great sources, add them in the comments!

Free Illustrations for Birth Professionals

Years ago, I created LOTS of simple line drawings for use in birth education materials. I’m putting them here for anyone who wants to use them for any perinatal education or birth support purpose, whether that’s for class handouts, PowerPoints, to show to a client over a video call, or whatever. Everything on this page is free for you to use, no need to credit me as the source. For any of them, just right click on it, and choose copy or save as.

Positions for Labor

Sitting or Resting

Standing / Moving

Forward Leaning

Pushing Positions

Anatomy

Maternity Care

Monitoring

Interventions

Complications

Fourth Stage / Skin to Skin

Breastfeeding

Anatomy

Positions

Breastmilk Expression

Birthplace Options

Babywearing

Rebozo Techniques

AV Aids for Birth Classes – Posters and Images

I’m gathering links to resources, and will continue to add more, but here’s some to get you started. I cover posters, handouts, and illustrations in this post. I have separate posts on where to find videos and 3-D models.

Childbirth Graphics is sort of the grande-dame of AV Aids. They’ve got pelvises, fetal dolls, placentas, posters, and handouts galore. Primarily physical products you can order and have shipped to you. They have digital versions of posters you could use in an online class. Durable and high quality.

Plumtree Baby. Handouts, posters, and PowerPoints. Like Childbirth Graphics, all good stuff, with a really great look.

Transition to Parenthood. I have around 100 free-to-use illustrations depicting labor and birth positions, maternity care interventions, breastfeeding, and more. All .jpgs you can copy and use wherever you want free of charge.

I also have lots of free printable handouts for birth classes. The Guide to Labor Support is a 2 page cheat sheet that covers the theories of fear-tension-pain and gate control, covers counter-irritants and hormones, and more. I have three wallet cards: questions for informed consent and two versions of a comfort techniques reminder.

Brilliant Activities for Birth Educators. This is not a site that sells AV aids… it’s a blog that tells you how to make your own! Lots of fun ideas for interactive activities.

Better Birth Blog – Lauren McClain, birth educator, has created lots of great visually appealing handouts on a wide variety of perinatal topics. They’re primarily digital files you can print or share with clients.

There are free handouts for childbirth ed students and doula clients at these sites, but I haven’t had a chance to review them in detail: Birth Arts and Childbirth Professionals International. (Best Doulas has created handouts from articles published elsewhere, but I would think about copyright issues for sharing those.)

HolmCreative. Shawna Holm has an Etsy shop with printed cards, a positions poster, printable PDF handouts, and vector illustrations.

Educated Birth. Cheyenne Varner creates fabulously inclusive infographics and illustrations that reproductive health workers can purchase to use as teaching tools. You receive digital files – .pdf, .jpg, .png. The basic use pricing is for people with one income stream (e.g. doula), extra use pricing is for professionals with multiple income streams (e.g. doula, CBE). Can then use with unlimited number of clients.

Queen City Birth Work has another great set of inclusive digital illustrations of birthing positions. All proceeds are donated.

Praeclarus Press has free PDF posters of breastfeeding and also labor support by doulas. Inclusive illustrations.

Royal Midwives – active and upright positions – at https://www.rcm.org.uk/media/2313/rcm-a3-positions-poster-download.pdf

Student Midwife Studygram. Jess is a NHS midwife in England. When she was in midwifery school, she began doing anatomy illustrations to help herself learn, understand and remember what she was studying. Now she makes those illustrations available for others to use. Flashcards or PDF’s.

It Starts with Birth on Etsy has printable handouts, and printable posters

Stanford Medicine Photo Gallery: Images of normal newborn appearance (milia, lanugo, etc.)

Birthing with Guinever. Has two versions of a stages of labor poster.

Cost Comparisons

There are many considerations in choosing AV Aids for your class. First, I encourage you to only choose images that show diverse people – diversity in race, orientation / gender / family structure, ability, etc. I think each of the providers listed on this page does a fair job at that, but some place this as a top priority.

Second, look for the ones which best meet your teaching needs and style.

I know that cost is a consideration for many birth professionals, so low cost is always a nice option, but I also balance that with the fact that the people who create these products are working hard to provide great professional images that support working people and deserve decent pay for that work.

I just wanted to give some sense of the cost of items, so tried my best to compare apples to apples. I looked for a Stages of Labor poster on each of these sites (images above). Childbirth Graphics: 22 x 28 stages poster $25. Plumtree Baby 18×24 stages poster $24; Better Birth stages poster 11×17 (I think) $25. Educated Birth – Labor positions poster with comfort techniques – 24×36 $52. HolmCreative has a 12×36 poster of positions for labor for $50. Student Midwife fetal station and mechanics of labor poster, 11.7×16.5, £8 = $12. Birthing with Guinever – .jpg image, free download.

More ideas?

For more links, check out the Pinterest pages for Foothills Birth Services and Tina Gibbs’ Antenatal Teacher board.

If you know of other great sources, add them in the comments!

Setting Expectations for Parenthood

In a journal article on “Mother’s Expectations of Parenthood“, authors Lazarus and Rossouw address the influence of unreasonable prenatal expectations of parenthood on the development of postpartum mood disorders. They make recommendations for antenatal classes that I think are worth consideration for childbirth educators:

“Current antenatal classes focus mainly on the birthing process; however… it is the transition that occurs once the mother is at home that is pivotal in the development of depression, anxiety, stress, and low-self esteem… An education program focusing on compromised infant, support, and self-expectations during the first year post birth should be created and incorporated into existing antenatal classes… This type of education program should perhaps emphasize the potential realities of having a child (such as a difficult and painful birthing experience or a baby with a more difficult temperament) but, most importantly, it should normalize the ambivalence and doubt that a mother may experience post birth, and stress the importance of reaching out for help and talking to others if she experiences even the smallest difficulty during the transition to becoming a new mother.

“This education program could also highlight how current social norms for new mothers as “super mums” is… not merely unattainable but rather it creates an environment that promotes the development of depression in new mothers, given that women feel strongly obliged to isolate themselves and conceal their true feelings when they are experiencing difficulties and/or depression post birth. These behaviors only succeed in further feeding the symptoms of depression by avoiding the issues at hand… If a healthy shift to new motherhood is to transpire, it is the rule rather than the exception that this transition may be accompanied by some degree of grief and loss and changes in mood.”

As a childbirth educator, or doula, do you encourage your clients to think about their expectations and be certain that they are realistic?

In my post on “Failing to Meet Your Own Expectations“, I offer some questions parents can ask themselves about their expectations for their parenting, and some ways to re-frame them to be sure they are attainable goals.

Key Research and Guidelines 2015-19

At the 2019 Lamaze Conference, Deborah Amis presented a Research Update. I watched it today – it is available at that link for $20. It is an excellent review of the most important research and research-based guidelines issued between 2015 and 2019. I will list here some of the items she covered, with links and a few notes, but I’d encourage you to watch the recording for all the details.

Here are the key research and guidelines you should be aware of – just listed in the order she covered them in her presentation.

WHO Statement on Cesarean Section Rates (2015) – “at a population level, caesarean section rates higher than 10% are not associated with reductions in maternal newborn mortality rates.” Here is a companion FAQ.

California Maternal Quality Care Collaborative (CMQCC) Toolkits. Each includes best practice tools and articles, care guidelines, and implementation guides. Toolkits include: Substance Exposure; Maternal Sepsis; Venous Thromboembolism, Cardiovascular Disease in Pregnancy, Obstetric Hemorrhage, Preeclampsia, Reducing Elective Deliveries before 39 weeks, and Toolkit to Support Vaginal Birth and Reduce Primary Cesareans and Implementation Guide, 2016

AJOG April 2019 – Safety Assessment of a Large Scale Improvement collaborative to reduce nulliparous cesarean delivery rates. Study of CMQCC efforts to reduce primary cesareans. Data from 119,000 births. NTSV cesarean rate fell 29.3 to 25% between 2015 and 2017, with no increase in poor maternal or neonatal outcomes.

AIM – Alliance for Innovation on Maternal Health – Patient Safety Bundles – “… a small, straightforward set of evidence-based practices … proven to improve patient outcomes.” Not new ideas, but a standardized approach for delivering well-established, evidence-based practices to be implemented for every patient, every time. Topics include: Safe Reduction of Primary Cesarean; Reduction of racial disparities; Obstetric Hemorrhage, Severe Hypertension in Pregnancy, Obstetric Care for Women with Opioid Use Disorder, Cardiac Conditions; Postpartum Discharge Transition, and more.

Lancet: Optimizing Caesarean Section Use – 2018 series. Reviews the global epidemiology and disparities in caesarean section use, as well as the health effects for women and children, and lays out evidence-based interventions and actions to reduce unnecessary caesarean sections.

AWHONN Save your life: get care for these POST BIRTH warning signs. Patient handout.

ARRIVE Trial. Study with 6000+ participants showed elective induction at 39 weeks yielded a cesarean rate of18.6% vs. expectant management rate of 22.2%, a 16% reduction in relative risk. Leads to ACOG Guidelines that “it is reasonable… to offer elective induction of labor to low-risk nulliparous women at 39 weeks gestation.” Also read Rebekka Dekker’s article on this in Evidence Based Birth, which includes a link to a one-page patient handout, which includes other ways to reduce c-s risk: midwifery care, continuous labor support, intermittent auscultation, etc. Dekker also links to responses to the ARRIVE trial and ACOG guidelines from ACNM and CMQCC. Summaries of the AWHONN response and SOGC response are on this Talking Points handout from Amis’ The Family Way.

JAMA 2018 – Effect of Immediate vs Delayed Pushing on Rates of Spontaneous Vaginal Delivery Among Nulliparous Women Receiving Neuraxial Analgesia. Shows no difference in perineal lacerations, endometritis, severe hemorrhage, transfusion, NICU, neonatal morbidity. Immediate pushing group had shorter second stage (mean 102 minutes vs. 134 minutes), decreased chorioamnionitis, decreased hemorrhage, decreased neonatal acidemia, decrease suspected sepsis. Delayed pushing had less 3rd and 4th degree tears; active pushing was 75 minutes vs 84. ACOG Committee Feb 2019 – “data support pushing at the start of the second stage of labor for nulliparous women receiving neuraxial analgesia”.

AWHONN’s Second-Stage Labor Practices Reduce Cesarean Births and Newborn Harm (2019) has 13 evidence-based, second-stage labor practices. (Article on Implementing Guidelines.) Provide info about both immediate and delayed, but a key guideline is respecting spontaneous urge to push.

ACOG – Approaches to Limit Intervention During Labor and Birth – 2017 and 2019. Also read Sharon Muza’s follow-up articles on these guidelines: Sharing ACOG’s Guidelines with Clients and her Research Update – ACOG Advises No Longer Laboring Down and Support of Family-Centered Cesareans. Guidelines include: laboring at home till active labor; doulas, intermittent monitoring, reducing AROM, using coping techniques and positions; oral hydration; pushing with urge to push, immediate pushing at 10 cm with epidural, and family-centered cesareans.

Physiologic basis of pain in labour and birth – Bonapace… Buckley. (SOGC) “…scientific literature supports the use of nonpharmacological approaches to pain management … due to benefits for the mother and child, including a reduction in the need for obstetrical interventions, labour augmentation, or Caesarean section.” Addresses Gate Control, Diffuse Noxious Inhibitory Control (counter-irritants), Central Nervous System control, continuous labor support, and the hormones of labor.

International Childbirth Initiative – 12 steps to safe and respectful motherbaby- family maternity care. Includes: affordable care, midwifery model, continuous support, non-pharmacological first option, benefit/risk considerations, and baby-friendly practices. (It’s similar to the Ten Steps of the Mother Friendly Childbirth Initiative from CIMS, from 1996.)

WHO update 2015 – Pregnancy, childbirth, postpartum and newborn care: A guide for essential practice. Includes 56 recommendations for labor and birth. Many are same as 1996 – midwifery, intermittent, food and fluid; mobility & upright positions, following urge to push, skin-to-skin. New: active labor begins at 5 cm; during active, may progress more slowly than 1 cm/hr; no interventions to speed up labor before 5 cm; delay cord clamping at least one minute; delay bath 24 hours.

AIMM study – Vedam et al 2018 – Mapping integration of midwives across the United States: Impact on access, equity, and outcomes. States with a better integration of midwives into the health care system had more spontaneous births, VBACs, breastfeeding and at 6 months; less interventions; less preterm birth, LBW, neonatal deaths.

Consortium for Safe Labor? I didn’t get the full citation on this… but Amis summarized that hospitals with physicians AND midwives had lower rates of induction, augmentation, c-s; had birth at a later gestational age, more NICU admissions; no differences in adverse neonatal outcomes or Apgars.

Midwifery Care for Low Income Women – fewer small for gestational age; fewer preterm, fewer LBW – “women who are more vulnerable benefit from the care of a midwife.” Study.

Listening to Mothers in California 2018 – survey of 2539 participants. Summarizes survey result data, but also includes quotes from parents who describe their maternity care experiences. Asked about choice of care provider and birthplace, maternity care preferences vs. care received, respectful and disrespectful treatment, and racial disparities. Here are a couple of interesting visuals from Listening to Mothers.

Teaching Birth Prep on a Portal

I recently wrote a review of Facebook Portal for those who are considering a purchase. On this page, I’ll just give you a quick overview, and then comment specifically on how well I think it would work for online childbirth preparation classes.

Overview

The Facebook Portal is a video-chatting device. You can also use it for streaming or surfing the web, but it was primarily designed as a device for teleconferencing software such as Facebook Messenger, What’s App, and now Zoom. (Not for Teams or Skype)

Zoom works fairly well on the Portal, although it does not have a few of the features you’ll find on your app on your computer – you don’t appear to be able to run breakout rooms or do polls from it. You also don’t seem to be able to share directly from the Portal, but you can easily share from another device without having to log it in to Zoom. See the full review for more details.

Audio Video Quality

It’s got really good speakers, multiple microphones and a camera with good video quality. The camera has movement tracking software, which follows you if you move around the room. I was hopeful that this would be good for birth classes, providing a better view of comfort techniques than I can manage with my laptop.

It turned out, as you can see in the second video, that the motion tracking did not work well for this purpose. The camera focuses around your face, so when you’re trying to demo foot placement for a lunge, the camera will show you from the waist up or even shoulders up.

You can do manual control of the camera, where you can zoom in or out, and aim it where you want it, so you can create just a nice wide angle that shows most of your body. It looks better and sounds better than it does when I use my laptop’s webcam. You’ll see this in the second video.

Using for Birth Classes

So, here’s how a few techniques for birth classes look on my laptop with its external mic.

Here’s how things look on the Portal – the first part of the video has the camera using motion tracking – the second part is manual control. You’ll notice even in the still images here that the color and picture quality is much better on the Portal than on my Lenovo laptop.

Conclusions

The Portal experience is not a game changer, and I wouldn’t necessarily run out to purchase one. However, if the price ($129 – 179 in November 2020) is manageable, I think the improved audio / video quality and the ability to get the wide-angled shot offer some appealing benefits for me.

For more info on using Zoom

I have LOTS of tutorials about how to use Zoom – for brand new beginners, experienced hosts, musicians, preschool teachers and more. Check out: https://janelledurham.com/guide-to-zoom/.

Note: the links to products in this post are affiliate links. If you click through to Amazon and purchase anything, I will get a percentage of the revenue. That helps support my work writing this blog and others.

Guide to Zoom

Many childbirth educators are now teaching their classes online. For those who are using Zoom, I wrote up a guide that has several tutorials, from the basic “how to join your first meeting” to becoming a more skilled participant, to hosting meetings, sharing video, playing live music, and more. It also includes lots of ideas for interactive games and learning tools you can use. Find it at: https://janelledurham.com/guide-to-zoom/.

Wallet Cards for Birth Classes

Long ago, I made small cards of the Key Questions for Informed Choice that I gave to students to keep in their wallets as a reminder. Recently, someone asked me for a copy of the file so they could print their own, and I discovered I had mis-placed it.

So, today, I created some new wallet cards, that you are welcome to use with doula clients, childbirth education students, or whoever would find them helpful.

Key Questions for Informed Choice

card listing key questions - benefits, risks, alternatives, timing

This file contains two versions of the key questions. Refer your clients to podcast episode 8 (or its transcript) to learn more about maternity care choices.

To learn more about how I teach clients the questions and how to weigh those against their personal goals and values, read about Teaching Decision Making.

Labor Comfort Techniques Reminder Card

labor comfort techniques card

I already had a two-page cheat sheet Guide to Labor Support. I created a comfort techniques wallet card to accompany it. Your clients can find the full Guide on the transcript of podcast episode 1 on Your Toolbox for Coping with Labor Pain.

There is more on the 3R’s in my episode on the Stages of Labor.

Visual Reminder of Comfort Techniques

comfort technique reminder card

If you feel like that first card is too wordy, and want something more visual, check out my visual comfort cards. These are not intended to stand alone. They would be best as reminders of concepts and techniques that you taught them, or that they can find in episode 4 – comfort techniques for labor. (The transcript for the episode includes a printable 2 page handout on these techniques.)

Printing the Cards

You could easily print these on paper or cardstock and cut them apart by hand.

I print my own nametags, so I always have “Name Badge Insert Refills” on hand, so I designed them to print on those. (They would also print on any of these products: 74461, 74549 or these Amazon brand cards. Note, those links are affiliate links, and I get a small referral fee from Amazon if you purchase after clicking on those links.)  These can easily be broken apart to create nice professional looking wallet size cards you can share.

Interventions – the Role Playing Game

Years ago, I created a Dice Game for Exploring Variations in Labor which I used when I taught a two hour class on interventions. I divide the class into three groups, and have them create three characters with different motivations, and at various points during the class, I have them roll dice and/or flip coins to see how the labors are playing out, then ask them to role-play how they think their character would respond to those circumstances.

I used the activity a few times, then my teaching schedule shifted to where I was mostly teaching refresher classes, breastfeeding and newborn care, so I shifted out of the habit of using it.

This weekend, I was scheduled for a 5 hour class which covered pain meds, interventions, cesarean, and postpartum. I decided this game would be a fun way to structure the majority of the class. I decided to start it by having them flip one coin and roll one die to determine where their character is on the pain medication preference scale. Then I asked them to create a character, decide WHY that was her pain med preference, and what support team and birth plan she’d have based on that. (Note: you could also include the medical mindset tool here.) Then we went from there, walking through:

  • what week in pregnancy labor started (and talking about preterm labor, induction, and decision making about induction)
  • how early labor started, how long it was, and how they’d cope and when they’d go to the hospital (to review that info from previous week)
  • how long their active labor would be, what they could do to move it along, augmentation, and whether they would choose pain meds based on the combination of their initial preferences and how labor was unfolding for them
  • how long pushing would take, what they could do to help, whether interventions would be offered, and what decisions they would make

The class went VERY well, with all the students really engaged, and really getting moments of insight into decision making and the need to be flexible about the details of the birth plan while still honoring the general intent. I also think it felt very non-judgmental, honoring the variety of reasons why people might make the decisions they do.

For example, our character with the -5 PMPS, who was a naturopath and planned a home birth ended up rolling on her first roll that induction was needed. So, we saw how that played out through the rest of the labor. Our character with the +6 requested induction and was counseled out of it, but then went into labor naturally at week 38, and had a fast early labor, and the epidural she chose, but then rolled a slower active labor, so we got to think through what that would be like.

Note: Although there’s lots of randomizing rolls and coin flips, I do sometimes adjust or nudge the results a bit. I want it to turn out that each character faces some challenges, but each ends with a vaginal birth and a positive experience. I cover cesarean after the role play is over.

There are so many ways you can adapt this idea, from a 10 minute review of the stages of labor, to a 30 minute labor rehearsal, or 2 hours on variation, or this ~4 hours class which includes stages review, practice of coping techniques, pain meds, and cesarean. Here’s a lesson plan for this class.