Childbirth Education Methods

There are several different “methods” that are taught in birth classes. When learning about possible instructors, find out where they were trained, and whether they have been certified by any organization. This will give you a good sense of where they are coming from. (Although to be honest, some instructors have evolved their own philosophy and style that may be very different from the official method of their original training.)

These are listed, in general, from most common to least.

Informed Choice Orientation. Many organizations, hospital educators, and independent educators do not really teach “a method.” They often draw from several of the methods below to cover a broad variety of techniques for women how to cope with labor, and how partners can best support a laboring woman. (A common metaphor is that they are giving you a “toolbox” of tools that you can adapt to your needs of the moment during labor.) Instructors also discuss the range of medical options in birth, and how to make informed choices based on current research based evidence and based on your own priorities as a family. Emphasis is on “freedom of choice based on knowledge of alternatives.” A major national organization with this emphasis is the International Childbirth Educators Association, www.icea.org. In western Washington state, Great Starts teaches this style of class, and since we have trained many of the educators in the state, this is a common method.
Class formats vary, as instructors design their own curricula.

Lamaze. Lamaze instructors used to teach a very specific method, but the organization has evolved over time, and now is similar to the “informed choice orientation” described above.
Many websites about childbirth education options have outdated information. Here is the historical background of the method. In 1951, a French obstetrician, Fernand Lamaze studied a Russian technique, which he helped to popularize in Europe and others brought to America. Called psychoprophylaxis (mind shield), it involved learning and practicing techniques until they became a conditioned response. So instead of tensing up and holding your breath in response to pain, you would remember to focus your attention on a breathing pattern or on an external focal point.
Modern Lamaze classes do still teach distraction, focal points, and breathing patterns. However, they are much more than that. They also recommend changing positions, hydrotherapy, massage, hot and cold packs, birth balls, and so on. Their approach to interventions and pain medications is also focused on informed choice. (They have a useful summary of their recommendations – Lamaze Healthy Birth Practices – at www.mothersadvocate.org.) The Lamaze philosophy is that birth is normal, natural, and healthy, and education can empower women to approach it with confidence. A class series is typically 12 hours long. To learn more, see www.lamaze.org and www.givingbirthwithconfidence.org

Bradley, Also called “husband-coached childbirth”. Emphasis is on trusting in the natural labor process and on natural childbirth without pain medication. Strongly advocates against pain medication and medical interventions. (Many of their students plan home births, and almost 90% of their students give birth without pain medication.) Classes address nutrition and exercise in depth. They encourage concentrated awareness of labor pain, observing sensations and body signals, rather than trying to escape them through distraction. Deep relaxation, slow breathing and massage are used. This method teaches active participation by partners in continuous emotional and physical support.

Series last 10 – 12 weeks, with 2 – 3 hours per class. Classes follow a formula, and are similar everywhere. They often meet in the instructor’s home. Learn more at www.bradleybirth.com.

Birthing from Within: Mentors (instructors) focus on birth as a journey and profound rite of passage, not just a medical event. They teach “birthing in awareness”, and the goal of the class is not to teach detailed information about obstetric procedures, but to guide parents on a journey of self-discovery. Classes are experiential, with group discussion, painting and sculpture, guided journaling, drumming, vocalizing, and practicing pain coping practices. Teach a pain coping mindset, encouraging moms to re-interpret pain as something to be expected but not feared. Pain medication is viewed as a reasonable option for particularly long and difficult labors. Minimal time spent on medical interventions.

Classes are typically 6 weeks long, 2 hours per class. www.birthingfromwithin.com

HypnoBirthing, the Mongan method: Inspired by the Fear-Tension-Pain theory of Grantley Dick-Read. Teaches a natural childbirth technique that uses deep relaxation, slow breathing patterns, and self-hypnosis to decrease fear and tension, which decreases pain, and encourage release of endorphins, the body’s natural opiates. Students learn the principles of self-hypnosis for birthing (goal is to achieve a profound state of relaxation – a feeling similar to daydreaming), the origin of pain, how fear affects labor and birth, visualizations for labor, preparing the body for birth, and the importance of bonding. Five 2.5 hour classes. The official curriculum does not include information on pain medication or on medical interventions. (Some instructors do add this information.) www.hypnobirthing.com/

Hypnobabies: In class, women learn self-hypnosis, and then practice at home every day. Birth partners listen to their own scripts, read handouts to learn to guide the mother into deep relaxation with hypnosis scripts, as well as provide physical and emotional support in labor. The deep relaxation allows the uterine muscles to work efficiently for a more comfortable birth. (One author describes the Hypnobabies techniques as hypno-anesthesia, which she says is more effective than the relaxation of Hypnobirthing.)

Unlike Hypnobirthing, Hypnobabies classes also cover nutrition, exercise, staying low risk, risks and benefits of routine medical procedures, birth plans, and positions for labor.

They report that 70-75% of their students report completely comfortable births. 10 – 15% describe mild to intense degrees of discomfort during late labor only. 10% were completely comfortable in early labor, but not later.

Six three-hour classes, with standardized curriculum. www.hypnobabies.com

CAPPA – Childbirth and Postpartum Professional Association. Similar to the informed choice method of ICEA. CAPPA has a less rigorous training and certification process than ICEA. www.cappa.net

Birth Works: Inspired by Michel Odent, who believes women need to give birth in any way that is comfortable for them, following their own intuition. Recognizes that there is no one right way to labor and birth. Covers slow deep breathing, and positions to enhance the opening of the pelvis. Also looks at how emotions and values impact labor and decision making. It is a ten week class, 2.5 hours per class, and they recommend that you take it early in pregnancy, or even before pregnancy as it includes information on choosing a provider and birth place and on nutrition and exercise which is most beneficial early on. www.birthworks.com

ALACE / International Birth and Wellness Project. Feel that birth should be a sacred passage and creative expression of love, not a mechanized medical emergency. Teach relaxation, breathing, visualization, mind-body integration. Believe that laboring women who feel confident and supported can have joyful satisfying births. For medical procedures, teach midwifery model of low interventions. www.alace.org

Apple Tree Family. A Christian based method that covers what to expect during pregnancy, birth, and parenting, but roots this in God’s word, the Bible. Parents-to-be learn how to cooperate with God’s design for a comfortable, natural, and joyful birth. www.appletreefamily.org

Prepared Childbirth Educators. This is not really a method, but another organization that trains nurses to be childbirth educators. Rooted in the medical model, may be best for those planning a hospital birth. www.childbirtheducation.org/ch_ed.html

Brio Birth, also known as Bradley Reborn: I truly have no first-hand knowledge. However, this site (http://birthscamreport.blogspot.com/) has lots of concerning allegations, including files for a lawsuit filed by the Bradley organization (AAHCC) against Brio Birth.

Deciding between all your options: There is a flow chart designed to help you decide between all your options. It is at http://birthnaturally.org/childbirthoptionsguide.pdf I was inspired by that flow chart to create ChooseBirthClass.

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