About Childbirth Education

Childbirth education: what are the options?

by Connie Banack CCCE, CLA, CPD

In this new millennium of incredible choices, it is no wonder that there is also an array of choices of which childbirth education classes are the best for you and your partner. There are at least ten certifying organizations for childbirth educators and each has a unique approach to childbirth. From the strict patterned breathing techniques and outward focusing taught in the past by ASPO/Lamaze instructors to the inward-focusing Bradley Method, all are as individual as each pregnant woman. Finding the best class is a combination of which technique will work best for you and your comfort level with your instructor and your classmates. In the beginning of "natural childbirth" classes in the 1930's Dr.Grantly Dick-Read gained his insights from watching middle class working patients give birth without help from drugs. He also worked in Africa, where he observed women giving birth on their own in rural villages. He saw the spiritual dimensions of birth and wrote of women's innate capacity to give birth successfully on their own and without medication. From his experiences he taught women to trust their bodies, using slow deep-breathing techniques to help cope with labour pain. His classes never caught on in popularity in North America, but are the basis of many programs today. 

During the same time, Dr. Lamaze was working in obstetrics and found the Pavlov experiments fascinating. He deducted that distraction during labour through patterned breathing techniques and using focal points would help women have pain free labours. Through his work he found this to be true if the labouring mother did the focusing and breathing effectively, having learned and practiced prior to labour. Today Lamaze has changed to incorporate deeper breathing techniques. Lamaze classes are primarily taught through hospitals or health units.

The International Childbirth Education Association (ICEA), founded in 1960, pushed ASPO/Lamaze to the left of centre. With noties to the health-care system, ICEA has always been eclectic in its approach to birth in which they incorporate sociology, anthropology and midwifery as well as nursing and medicine. ICEA was the first national organization to focus on the psychological aspects of birth. ICEA-certified educators have largely replaced Lamaze educators in many of the hospitals and health units even though they are still commonly referred to as "Lamaze classes."

A different approach was from Dr.Bradley and his "Husband-Coached Childbirth" philosophy which originated from his observation that women coped better and had better birth experiences when their husbands were present. He also found that the father-infant bond developed faster with the father present during birth. The Bradley method is now well known and it has played a very important role in allowing fathers into the hospital birthing rooms.

During the 1970's a second wave of childbirth organizations came into being in North America and Britain. This second generation focused on alternatives to standard medical and hospital procedures and practices. Among them the National Association of Parents and Professionals for Safe Alternatives in Childbirth (NAPSAC) founded by a couple in North Carolina, challenged the assumption that a hospital was the best place for birth. Rahima Baldwin, a Michigan midwife, founded Informed Homebirth in 1977, which is now the Association for Labor Assistants and Childbirth Educators (ALACE, pronounced Alice). ALACE trains both Labor Assistants (commonly called doulas) and Childbirth Educators who "teach relaxation and coping tools to work with pain and discomfort. We respect birth as an intimate act and a creative expression of love. We respect obstetric procedures as beneficial in some circumstances but potentially detrimental when applied routinely. Our goal is to help women reclaim trust in their ability to safely and dependably give birth."

The rising cesarean rate in the US brought about several women-founded organizations focusing on grassroots education for cesarean prevention. One of these, the Cesarean Prevention Movement, now the International Cesarean Awareness Network (ICAN), brought about another form of childbirth education known as Birth Works. Suzanne Arms explains in Immaculate Deception, "This teacher training program focuses on prevention of unnecessary cesareans and increasing the number of women having vaginal births after having cesareans. The underlying premise is that women innately know how to give birth successfully; they need to rediscover their bodies' wisdom and learn how to listen to their bodies. The approach is psychological as well as physiological and the teachings of a number of prominent authors in the childbirth movement have been drawn upon to create a holistic approach."

One of the newest organizations, formed to fill a need to increase professionalism and accountability within the childbirth education, labour doula, and postpartum doula professions, is the Childbirth And Postpartum Professional Association (CAPPA) and CAPPA Canada. Their focus is in providing women and their partners with the tools they need to birth as they choose, with true informed consent. CAPPA's educators strive to not involve guilt but rather empower women to choose the kind of birth that is best for them, be it medicated or un-medicated, intervention-free or full of traditional interventions. Their belief is that, given the facts, more women would choose a natural birth for themselves and their babies.

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Two colleges in Canada also provide Childbirth Educator training through their continuing education or nursing programs: Douglas College in Vancouver and Humber College in Ontario. Their in-depth, two-year programs provide a solid background of knowledge about all aspects of pregnancy and childbirth.  On a different note, Christian Childbirth Education certification can be obtained through Apple Tree Family Ministries and Titus 2 Birthing, both having a strong biblical basis in their beliefs and training.