Abstract
Childbirth educators can become a part of reform efforts to improve maternity services by helping to create consumer demand for such services.
Keywords: birth environment, advocacy, childbirth education
The mission of Lamaze International is education, advocacy, and reform. To meet the mission of promoting excellent education, Lamaze International offers programs to prepare childbirth educators (log on to www.lamaze.org or call 1-800-368-4404) and a certification exam that leads to a Lamaze Certified Childbirth Educator (LCCE). Advocacy and reform need a strong voice and, thus, Lamaze was instrumental in forming the Coalition for Improving Maternity Services (CIMS). This coalition continues to flourish. I encourage you to visit their web site (www.motherfriendly.org) or call the CIMS national office at 1-888-282-CIMS.
In this issue of The Journal of Perinatal Education, Carole Van Der Woude makes the case for a change to a birth environment that better fits her professional philosophy (see pp. 34-37). She is to be congratulated for following her beliefs. On a larger scale, changing the birth environment requires the consumer's voice, like the one we heard in the 1960s and '70s when laboring women demanded to be awake and both parents worked to promote policies to allow fathers in the delivery room. By the time expectant parents come to your childbirth preparation classes, they have selected their birth environment by virtue of having selected their care provider. Advocacy needs to begin earlier. Thus, in working towards its advocacy role to improve maternity services, CIMS reaches out to women as they select their source of care.
The CIMS document, “Having a Baby? Ten Questions to Ask,” is written in easy-to-read language. It begins by asking, “Have you decided how to have your baby? The choice is yours!” The brochure presents several paragraphs, each explaining the relevant details of the following 10 questions that expectant parents are encouraged to ask:
Who can be with me during labor and birth?
What happens during a normal labor and birth in your setting?
How do you allow for differences in culture and beliefs?
Can I walk and move around during labor? What position do you suggest for birth?
How do you make sure everything goes smoothly when my nurse, doctor, midwife, or agency need to work with each other?
What things do you normally do to a woman in labor?
How do you help mothers stay as comfortable as they can be? Besides drugs, how do you help mothers relieve the pain of labor?
What if my baby is born early or has special problems?
Do you circumcise babies?
How do you help mothers who want to breastfeed?
This entire document for parents and the corresponding document for health professionals, the “Mother-Friendly Childbirth Initiative,” can be obtained from the CIMS web site (www.childfriendly.org). With complete attribution, both can be freely reproduced in whole or in part. If you prefer a polished document, single copies and bulk prices are available at 1-888-282-CIMS.
Several years of work produced this well-worded, simple document for consumers. Now it is up to the coalition member organizations such as Lamaze International to get the document into the hands of members and encourage the members to put it into the hands of women early in their pregnancy or before their pregnancy.
You can help create the consumer demand for improved maternity services by obtaining this document and putting it into the hands of women and young childbearing families in your community. Let women know their choices while the choices are easier to make—that is, before the time they select their maternity service.
In 1971, I attended a small workshop conducted by Dr. Irwin Chabon who wrote a book on prepared childbirth, Awake and Aware. This was when we were working to allow fathers in the delivery room. When I asked him to provide facts and statistics about various types of interventions, he told me to forget trying to advocate with statistics. Rather, he said, I should use the power of the purse and then watch the care providers' birth philosophies spin. I thought of him when all three hospitals in my town began accepting fathers in the delivery room within six weeks after the first hospital did.
In summary, as childbirth educators, an important part of your role in advocacy and reform is to get information into the hands of the consumer at an appropriate time for them to make choices. It will help if these choices have economic implications for their care providers. Through its work with CIMS, Lamaze International has supported giving you the materials to help do just that. Retrieve the full version from the CIMS web site or call CIMS and order the materials. Then, write and tell us the most creative ways that you and your community chose to use these materials.
Thoughts on Advocacy
The probability that we may fail in the struggle ought not to deter us from the support of a cause we believe to be just.
—Abraham Lincoln
Finish each day and be done with it. You have done what you could. Some blunders and absurdities no doubt crept in; forget them as soon as you can. Tomorrow is a new day; begin it well and serenely and with too high a spirit to be cumbered with your old nonsense.
—Ralph Waldo Emerson
Even if you're on the right track, you'll get run over if you just sit there.
—Will Rogers
There are two modes of establishing our reputation: to be praised by honest men, and to be abused by rogues. It is best, however, to secure the former, because it will invariably be accompanied by the latter.
—Charles Caleb Colton
When you are right you cannot be too radical; when you are wrong, you cannot be too conservative.
—Martin Luther King Jr.
To get thine ends, lay bashfulness aside; who fears to ask, doth teach to be deny'd.
—Thomas Herrick
Many persons have a wrong idea of what constitutes true happiness. It is not attained through self-gratification but through fidelity to a worthy purpose.
—Helen Keller
A loud voice cannot compete with a clear voice, even if it's a whisper.
—Barry Neil Kaufman