Tibbetts1

Alisa Tibbetts
Shana Youngdahl
Pregnancy and Birth
6 November 2013

Childbirth Education for the Modern Woman

You never know what to expect in childbirth until its happening. So many things
can happen during the duration of labor and childbirth, it is an experience completely
unique to each woman. With of all the variables, the course of labor and childbirth can
take many directions. Some womens labor spans days, others no more than a few hours.
Some women have a water birth, other women opt for a medicated birth in a hospital
bed. At many points in labor, women have decisions on what can be done to help with
the delivery of their baby. In todays society, the view of what a normal and safe labor is
getting slimmer and slimmer. As of 2009, less than 1% of births in the US took place at
home, the other 99% taking place in some sort of medical facility. Is this shift into a
medical environment for the better? The answer to that question is unique to each
mother, unfortunately, many mothers arent making the best choice for themselves
because they arent cognizant of all of their options. All birthing options for women
should be available and well known.
Women have been giving birth since the dawn of time. From a mothers womb is
where civilization began. Womens role inside civilization, however, has changed. In the

Tibbetts2

past, the woman was to stay at home and raise the children, while the man provided for
the family. As time continued, women gained rights, they stepped out of the home, and
they too became providers for the family. As society shifted from stay at home moms, to
moms in the workplace, pregnancy and childbirth education has had to shift to the
womens changing schedule. In the 1960s into the 1970s, average childbirth education
classes were three days a week and lasted about two and a half hours. As of 2009, the
average childbirthing education class are one to two days a week, in one hour sessions.
This decline in class seat-time makes it not only so less information can be learned, but
the women in the class have less of a feeling of support in the class and are less likely to
vocalize concerns or questions. The mother is less prepared for labor, and she is less
empowered to make a confident decision for herself and her child. (Livingston).
As the overall expectation of childbirth has changed in society, the content of
childbirthing class has had to change as well. In the 1960s, when formal childbirth
education begun, society was beginning to shift away from scopolamine and other
opioids once used to achieve twilight sleep birthing, and instead was looking for other
methods. These classes armed women with knowledge about the birthing process as well
as techniques on relaxation and breathing during labor and the importance of coaching
and support. These classes were often taught in small groups which allowed the mothers
to have a close bond with not only each other, but the instructor, allowing for the most
support and outlets of information. As time advanced, and duration and attendance of
childbirthing classes began to decline, the content and atmosphere of the classes
changed as well. Childbirthing classes had become institutionalized. Instead of small

Tibbetts3

group setting in the home or office of the childbirth educator, childbirthing classes
became large group classes held in hospitals in which the childbirth educator is an
employee. This puts the childbirth educator in the dilemma of giving the mothers
non-biased information that will allow them to make the best decision for them and
have a successful career at the hospital. Mothers taking classes inside of a hospital wont
receive good information about home births, or having a midwife. It also only makes the
mother comfortable with a hospital setting. The change from small group to large group
has also caused for the women to be less active in the classes, and less likely to voice
concerns or question content of the classes (Lothian).
Midwifery/ homebirth not being legal in all states makes this unavailable for
some women, as well as making it a taboo topic that isnt talked about and isnt well
known. Birth to many is to be considered a normal life occurrence. Every single one of
us, will first hand experience childbirth at least once in our lives. Of the 50 states in the
US, in 23 states it is illegal to hire a direct-entry midwife (The American College of
Obstetricians). These laws then raise the question to mothers not only that live in the
states where they legally cant have a homebirth, but all other states that if giving birth
in a setting where medical intervention cant be instantaneous is illegal, then surely
medical intervention must always be needed. This makes women not question any of the
medical inventions recommended from doctors because they are viewed as needed, even
though the cons of these inventions may outweigh the pros. However, if women were to
be more educated in the various labor options, they would be empowered to make a
decision for themselves.

Tibbetts4

The content, as well as the duration of childbirthing classes, and societys taboo
about some options of childbirth have made many mother neutral over the decisions
that they have. Because of this, they allow doctors and other healthcare professionals to
make the decisions for them. Although this isnt a bad choice, mothers should
understand that delivering their child in best way for both the child and the mother isnt
the only concern for the doctor. Doctors also face legal ramifications if something were
to go wrong during delivery. In fact, 45% of hospitals report that the professional
liability crisis has resulted in the loss of physicians and/or reduced coverage in
emergency departments. Because of this, one in seven Obstetricians believe that
delivering babies is too much of a legal liability, and they no longer do it (Malpractice
Defense). Beyond legal ramifications, there are also implications of doctors wanting to
speed up the labor process in order to limit the duration of the labor. However, there is
evidence that childbirth with medical intervention can often cause a butterfly effect for
more medical interventions. As shown in the figure below, once one medical
intervention is performed, it becomes more likely that there will be further medical
interventions (Livingston). If more women were to know that just deciding not to be
induced and then saying no to an epidural would cut their likelihood of having a
c-section from 31% down to 5%, then maybe they would second guess what the doctor
overseeing them suggested (Livingston).

Tibbetts5

All birthing options for women should be available and well known because
without it, the mother and the childs life is at risk. ListeningToMothersII,which is a
published questionnaire of a pregnancy magazine,suggests that there is a correlation
between declining attendance of childbirth classes, and the increase of induction,
c-sections, and maternal mortality rates (Lothian). The only way to turn these stats
around is to arm women with information. A doctor needs to think about more than
what is best for mother and child, but the mother doesnt. The power of decision should
shift away from doctors and into the mother herself. Every childbirth is unique, and
should be treated as so. When a mother options are known and readily available to her,
she is able to make the best decisions for herself and her child in the optimum space

Tibbetts6

resulting in a better birth experience and lower risks of complications.

Works Cited:
"The American College of Obstetricians and Gynecologists Issues Opinion on Planned
Home Births." Hcp.obgyn.net. N.p., n.d. Web. 06 Nov. 2013.
<http://hcp.obgyn.net/pregnancy-and-birth/content/article/1760982/1977662
>.
Livingston, Connie, and Caroline Brown, eds. InternationalJournalofChildbirth
Education 24.1 (2009): 1-38. Print.
Lothian, Judith A. "Childbirth Education at the Crossroads." TheJournalofPerinatal
Education 17.2 (2008): 45-49. NCBI. U.S. National Library of Medicine. Web.
06 Nov. 2013. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2409156/>.
Lothian, Judith A. Graph. "Childbirth Education at the Crossroads." TheJournalof
PerinatalEducation 17.2 (2008): 45-49. NCBI. U.S. National Library of
Medicine. Web. 06 Nov. 2013.
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2409156/>.
"Recent Statistics- Malpractice Defense Services." RecentStatisticsMalpractice
DefenseServices. N.p., n.d. Web. 06 Nov. 2013.
<http://malpracticeservice.net/html/recent_statistics.html>.

Tibbetts7