Study: Could Changes To Birth Classes Result In Better Birth Outcomes?

Study: Could Changes To Birth Classes Result In Better Birth Outcomes?

Birth education classes became popular around the 1960s in an attempt to chance the concept of birth as an illness that needed medical assistance.

Today classes have evolved from the standard weekend course at your local hospital – there are many types and styles of birth course available.

Birth education is worth investing in, even if you’re sure you’re getting an epidural.

Choosing the right birth course can make all the difference between a positive and empowering experience and one that leaves you feeling disappointed at best, traumatised at worst.

Are Birth Classes Necessary?

The vast majority of women give birth in hospital and estimates suggest around 98% of those women have some form of intervention during labour.

Medical interventions are so common today, most women have come to see them as the norm and are often unaware they may not be necessary or best practice.

A childbirth course trialed by Western Sydney University has demonstrated how being informed can significantly reduce medical interventions.

While the peer-reviewed study was small, the results were startling: a 65% lower epidural rate and a 44% lower c-section rate than women offered a standard hospital birth course.

There was also a significant reduction in augmentation of labour (having artificial oxytocin to speed up labour) and a shorter second stage of labour, meaning less time pushing.

The study course included evidence-based techniques from complementary medicine, such as yoga, breathing, massage, partner support, acupressure and visualisation.

As well as education on how women’s own hormones could be used to manage pain, these techniques provided women with plenty of options during labour, reducing the need for epidurals.

Professor Hannah Dahlen and Dr Kate Levette, an Adjunct Fellow at Western Sydney University’s National Institute of Complementary Medicine, conducted the study to see what effects birth education has on epidural use for low-risk, first-time mothers.

Professor Dahlen said the study shows changes in childbirth education is not only necessary but required as a matter of urgency.

“Childbirth education came about in the 60s and 70s to empower women and their partners to make choices and take control of their labours and birth. In a way childbirth education was a revolution and protest against the over-medicalisation of birth and lack of choice.”

“Then we incorporated it into hospitals and civilised and tamed it so to speak, so women and their partners would be cooperative with what we had on offer, or wanted to offer them. I think it is time for another revolution in childbirth education so it can return to doing what is was designed to do – create powerful parents not fearful ones.”

What Birth Courses Are Available?

There are basically two ways you can prepare for birth: independent birth education or hospital birth classes.

Hospital birth classes are usually run by midwives who are experienced in hospital birth and the policies which guide how they do their job. Most courses are held over a few days and cover a lot of information about pregnancy, birth and baby care. The birth information focus is generally on when medical interventions will be necessary rather than on what normal birth is and how to cope.

Independent birth classes come in many different forms. Popular courses include many different types of hypnobirthing, active birth classes, yoga based classes, natural birth classes… the list goes on. If the course is teaching one main focus, the question remains – is this going to be enough for you on the day?

What if everything you learned about active birth went out the window during active labour and you had nothing to fall back on? It’s likely at this point you may find yourself questioning your ability to go on without pain relief or accept interventions you wanted to avoid.

Important Questions To Ask When Choosing A Course

There are a number of ways to make a decision about the right course for you.

You can usually view the course programs online and it can be a good idea to call the instructor to ask the following questions:

How Does The Course Cover Labour and Birth?

Many women aren’t aware labour isn’t a straight line of contractions ending in pushing out a baby. Labour has emotional and physical elements which can be affected by the people around you, the environment you are in, your internal voice and beliefs.

It’s critically important to know how those factors will impact on you during labour and ways to make sure you feel safe and supported. Only knowing what pain relief options are available can set you on the path to believing natural birth is for other women not you.

Understanding exactly how your body works during labour and why can increase your chances of avoiding the numerous procedures most women expect to have during pregnancy and labour.

Birth is a peak physical performance, comparable to running a marathon or climbing a mountain. Without preparation for these events, how do you expect to achieve a positive ending or even finish in one piece?

When you know how normal labour and birth is meant to unfold, it can help you to overcome any fears or concerns you have. If you are a low-risk pregnant woman, you are more empowered to choose care providers and birth settings which will support your desire to have a natural birth.

Even high-risk pregnant women can benefit from understanding the benefits of a normal labour. Whether you need an induction or a c-section, having the knowledge to make your baby’s birth as positive as possible goes a long way to helping you cope with a challenging pregnancy or birth.

Learn more about undisturbed labour and why it’s great to aim for one.

Do You Teach More Than One Type Of Pain Management?

Courses which focus on just one type of pain management can leave you unprepared for a change in your contractions or dealing with transition when you are in labour.

Courses which include both hypnobirthing and active birth skills will ensure you have plenty of tools to use during the course of your labour. Many women believe they need to be active all the way through labour and end up exhausted when it comes time to push.

Other women want to calmly breathe their baby out but end up finding they need to roar and swing from their partners shoulders – they may not be prepared for this difference if they have only learned hypobirthing.

There are many options for natural pain relief during labour.

Does Your Course Teach Decision-Making Skills?

The best laid plans and intentions don’t always eventuate – factors can intervene late in pregnancy or during labour which means you have to make some choices about how and when your baby is born.

Medical interventions can be life saving when needed but unfortunately many women find themselves having interventions because they didn’t know they had a choice. They may not be fully aware of the process of informed consent and believe they have to go along with hospital policy.

Having the confidence and skills to ask questions of your care provider and understanding the risks and benefits of your options can go a long way to ensuring you feel in control.

A course which teaches these skills allows you to make your birth experience positive if medical intervention is necessary or chosen by you. It also encourages you to communicate with your care provider, birth support team and partner about your wishes and preferences.

It’s important to know about your rights as a maternity consumer in your area. Your care provider should always support you to make informed decisions on aspects of your care.

Find out more about informed consent.

How Is Your Course Presented?

This is important – two days of sitting on a chair listening to large amounts of information is enough for most people to tune out. Courses should involve interaction, hands-on practice and team building skills.

Your partner or birth support person needs to be confident and prepared if they are going to support you effectively during labour. Often partners feel they will either be a ‘spare wheel’ or worry they won’t know what to do on the day. The course you choose should involve and engage them in how to practically help and support you during labour.

Find out more about how private birth classes can give you an edge.

There is a lot of choosing to do when you’re pregnant, and the responsibility is on you to be as informed as possible to make the best decisions for you and your baby.

Choosing the right birth preparation course is probably one of the most important choices you can make. What you learn about birth will help determine how your birth unfolds – not knowing your options means you have no options to choose from.

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Sam McCulloch Dip CBEd CONTRIBUTOR

Sam McCulloch enjoyed talking so much about birth she decided to become a birth educator and doula, supporting parents in making informed choices about their birth experience. In her spare time she writes novels. She is mother to three beautiful little humans.


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