Perhaps the most important decision you will make after choosing your midwife or doctor and the place of birth is selecting your childbirth educator. She will almost certainly be your primary source of information on how to cope with labor. She can -- and should -- help you have a healthy pregnancy and complication-free labor, make informed choices about your care, have a smooth transition into parenthood, and breastfeed successfully. Childbirth educators can also guide you to other resources such as books and Web sites and can refer you to childbirth-related services, as, for example, labor support providers (labor doulas), postpartum home help (postpartum doulas), or lactation consultants. You can see why you want to consider carefully whom you choose.
What should you look for in childbirth preparation classes?
Independent educator: Most commonly, childbirth preparation classes are taught through hospitals, but hospital or clinic-based classes have a strong potential drawback: conflict of interest. It is in the hospital’s and obstetric staff’s interests to have patients who will comply with policies and not make waves by questioning or refusing them. Unfortunately, medical research has shown many aspects of typical, routine obstetric management to be neither safe nor effective. Hospitals may give their educators complete freedom to teach as the educator sees fit, or they may not, in which case, you won’t learn about these. As the authors of “A Good Birth, A Safe Birth” observe, “If you don’t know your options, you don’t have any.” You may also not get an objective picture of pain relief during labor. Labor epidurals generate significant revenue and subsidize having obstetric anesthesiologists available 24/7 to deal with the rare emergency. Hospital-based educators are often told not to discuss the potential problems with epidurals. You may decide for yourself that the benefits of an epidural outweigh the possible problems, but you should have the opportunity to make an informed decision.
Certified educator: Certification by a national organization doesn’t guarantee excellence, but it does ensure that the educator has had special training and has met some set of criteria for knowledge and skills. Many hospitals simply have their nurses teach classes, but having a nursing degree does not qualify you in and of itself to teach childbirth preparation classes.
Sufficient time to cover the topics: Fewer classes in the series and fewer hours per class both increases profits and meets the approval of busy, tired, expectant couples. However, it takes time to learn new skills, get questions answered, and explore issues. Lamaze International recommends at least twelve instructional hours per series. Based on my experience as a certified Lamaze teacher, I think 15 hours is the minimum for a thorough, first-birth, childbirth preparation series.
Small classes: Childbirth classes should be interactive. You want classes that are big enough for a good group process yet small enough for you to get individual attention and assistance and where you won’t feel shy speaking on intimate or sensitive topics. Lamaze International says that six to ten couples is ideal and sets a maximum of twelve couples.