Continuing Education Module—Lamaze Parents Magazine: More Than a Giveaway

Abstract

The Lamaze Parents magazine is an annual publication produced by Lamaze International to inform parents and childbirth educators on issues related to healthy birth preparation, normal birth, and parenting. The author of this column introduces teaching strategies for childbirth educators and doulas to use in tandem with the magazine's content in order to enhance their efforts in sharing current, evidence-based information with expectant parents.

As a childbirth educator, what do you do with the Lamaze Parents magazine (referred to here as LPM) after you have handed it out, along with the freebies inside, to class participants? Is the magazine meant just to be a giveaway to help expectant parents feel good about the Lamaze name? Or is it more?

Every year, a tremendous amount of time and talent helps produce LPM. Authors are selected for their evidence-based knowledge on a particular topic, their ability to empower parents through their words, their experience with normal birth, and their willingness to contribute to the magazine. The iVillage Parenting Network staff—together with Sue Majoris, Chair of the LPM Committee, and members of the LPM Committee—edit the magazine to ensure its information promotes Lamaze philosophies of birth, parenting, and breastfeeding and adheres to the advertising and publishing standards set by Lamaze International's board of directors.* Yes, the magazine displays numerous advertisements; however, a large amount of advertising is necessary to help finance the magazine's quality production. Furthermore, additional advertisers are needed because LPM and Lamaze International adhere to the World Health Organization's international policy on the advertising of breast-milk substitutes (World Health Organization, 1981). Every advertisement, article, and photo in the magazine must reflect Lamaze philosophies, a publishing standard that offers an excellent opportunity for educators to use LPM as a resource for teaching parents about evidence-based information. Marlo Robinson, an LCCE educator in Florida, tells how she does just that:

My teaching trick for using the LPM is to pull out specific articles on different topics, laminate them, and pass them around in class. Then I split the class into two groups and have each group evaluate whether the article is evidence-based or media-market hype. Each group discusses why they think this article falls into a particular category. Then, we have a discussion on the importance of educating themselves on issues important to them. To bring it to a more personal level, I give other evidence-based Web sites and journals, books, etc., and have them research one birth issue important to them and present it in our next class session. (M. Robinson, personal communication, August 18, 2005)

The Lamaze Parents magazine and Lamaze International adhere to the World Health Organization's international policy on the advertising of breast-milk substitutes.

Lamaze Parents magazine is a tremendous communication tool for Lamaze International to keep the normal-birth message in the public's mind. The magazine is distributed to millions of expectant parents and is available in Spanish and English versions. Additionally, LPM is provided to all childbirth educators, and many hospitals distribute the magazine.

Lamaze International's mission and vision statements are printed on the first page of every issue of LPM. Many creative solutions are available to enliven the task of teaching these statements in class. For example, childbirth educators can encourage couples to read the philosophy statements and share with the class their own or others' experiences related to each particular statement. This technique may take more time than you expect because it might generate further class discussion about such topics as inner wisdom, how birth profoundly affected a family member, why one might not choose medical interventions, and the safety of birth in birth centers and homes. Perhaps you do not plan on spending that much time on seven little sentences; however, in the ensuing discussion, you will have encouraged expectant parents to make birth real for themselves and investigate the many parenting styles and medical interventions they may choose as health-care options for their children.

This teaching technique might generate further class discussion about such topics as inner wisdom, how birth profoundly affected a family member, why one might not choose medical interventions, and the safety of birth in birth centers and homes.

LPM offers another important benefit to expectant parents in that it places value on information they need in birth, not on what they do not need. If you have some years on you with LPM and Lamaze International, you may have noticed the changes in the magazine's pain-relief section. The 1990 edition of LPM (yes, I have some back issues and some years on me) devotes an entire page to listing pain-relief medications by drug classification and providing short explanations of how the medications are administered. The list also describes the advantages and disadvantages of each medication. I taught the contents of that page so frequently that I can recite the list by heart. In LPM's 2005 edition, the pain-relief section is modified to include a short box displaying the most basic information on commonly used medications. The remaining space in this section includes discussions on when medications are beneficial in birth and how medications change labor and birth. It also provides suggestions for minimizing the risks of pain-relief medications. A teaching strategy for the 2005 edition of LPM's pain-relief section might be to point out Sue Majoris' article on making informed decisions (p. 14) and follow it up with a discussion focusing on minimizing the risks of medications. Ask the parents in your class to describe how these suggestions might help reduce pain and whether the strategies suggested are available to them. For example, encourage a class discussion on how allowing labor to start on its own enables the mother to eat and drink when she desires and to follow the urge to move into comfortable positions. Point out that, when a woman does not feel a need to hurry her labor along, she will have the personal distractions she needs to relax and let labor progress normally.

Yes, you can use the Lamaze Parents magazine as a giveaway to your class participants. They can tear open the wrapping, take the free stuff, and just toss that magazine full of advertising. However, you have the opportunity to use this treasure of some of the birth world's most notable authors to let expectant parents know they really can trust their inner wisdom to guide them through birth's incredible experience. The fact that LPM has so many ads can give you the opportunity to discuss how advertising changes expectant mothers' perceptions of their body's ability to grow a healthy baby, give birth, and feed that incredible baby a substance (breast milk) that cannot be replicated in the laboratory. You can also discuss why Lamaze chooses to deny itself many dollars' worth of formula advertising. If you merely hand LPM to the parents in your classes, it will take on the appearance of all the other giveaways. Show expectant parents how unique they are and how unique their births will be. Show them the treasures in the Lamaze Parents magazine.

To help childbirth educators and doulas use this normal-birth magazine more effectively, the following paragraphs illustrate teaching strategies for introducing the various topics presented in each section of the LPM 2005 edition.

“ABOUT LAMAZE INTERNATIONAL—VISION STATEMENT” (p. 1)

In a column published in The Journal of Perinatal Education, I described several ways to integrate Lamaze International's vision statement in childbirth education classes (Hotelling, 2004b). One way that works well for a variety of audiences is to invite participants to recall silently the most normal birth story they have ever experienced, heard about, or seen on television. Then, ask class participants to stand. Tell them that as you describe each of the six evidence-based care practices that promote, protect, and support normal birth (as outlined in the vision statement), they may remain standing if the care practice happened in their particular memory of a normal birth. If the care practice was not available to the mother, the participant must sit down. This technique is a great way to identify just how many people in your class have already been touched by normal birth.

“PRESIDENT'S LETTER” (p. 4)

Ask class participants if they wonder why a male is the current president of an organization that focuses on a female biological function. The impressive answer is in his letter.

“TOP TEN BOOKS” (p. 10)

If parents in your class have read these books, they can share their thoughts on how helpful these books are. If they have not read them, consider asking class participants to list their own top 10 favorite books about pregnancy, birth, and parenting. Class discussion can focus on what types of books either empower or disable mothers in normal birth. Having these books in your lending libraries increases the likelihood that they will be read.

Class discussion can focus on what types of books either empower or disable mothers in normal birth.

“YOUR WELL-BEING” (pp. 12–14)

“Consider Prenatal Yoga”

If you or someone in your class is experienced in yoga, consider beginning the class with some yoga relaxation techniques, followed by a discussion of how yoga benefits mothers when they are pregnant, birthing, recovering from birth, and dealing with life's every-day challenges. When discussing breathing techniques, ask if any class participants use yoga breathing techniques and encourage them to employ the same skills in labor and birth. Class practice increases information retention. Additionally, parents who would not have thought of trying yoga might find it is just what they need to invoke calm during those first weeks and months with their new infants.

“Sex Late in Pregnancy and Beyond”

Divide the class into two groups, according to gender. Encourage the men and women to consider the issues in this section and discuss the ones appropriate to them and about which they feel comfortable. If group questions arise, facilitate the discussion by providing evidence-based information, when needed.

“Eat For Energy and Health”

Ask class participants what their parents fed them as children and how they plan to feed their own children. Their answers can bring to light issues such as pop versus water, what infants need nutritionally, recommendations for the length of exclusive breastfeeding, why Americans face huge obesity-related health problems, and how eating in front of the television is less healthy than eating with the family at the table.

“A DAY YOU'LL NEVER FORGET” (p. 16)

Sometimes, parents just like to relax and be read to. This is the story to tell them. While you read aloud, they may nibble on nutritious snacks and beverages or simply massage each other. Another strategy is to assign the reading for homework and ask class participants to interview someone who is both over 60 years old and has given birth. As a home-care nurse, I treasure the stories my clients tell me, and I carry a tape recorder to document their birth stories. It is so empowering to listen to the older generation's experiences of birth and to compare them to the horror stories parents hear today. The elders' birth stories do not include the fear often presented in today's depiction of birth. The longer ago the birth experience, the more likely you are to hear that the birth took place at home, with the expectant mother surrounded by supportive companions.

“PREPARING FOR BIRTH—TRUST YOUR BODY AND YOUR LABOR GUIDE” (pp. 19–25)

Ann Tumblin, an LCCE educator in North Carolina, created a list of questions to spark class discussion that leads to the participants' realization that they have traveled uncharted waters before, and they have the resources to do so again. She distributes the questions in class and invites participants to discuss the answers with each other:

Life Challenges

1. Can you think of a personal challenge that you have faced sometime in your life? It may have been related to a physical challenge, educational challenge, or an emotional challenge. Describe at least one challenge you have faced.

2. How did you handle that challenge? Try to remember the phases you may have passed through—such as, “I can't do it”—until you reached completion. What skills did you use? Did you call on others for help?

3. How did you feel as an individual as you met that challenge?

4. If you faced another challenge today, how would you want your partner to be of help to you? (A. Tumblin, personal communication, August 18, 2005)

After a suitable time for reflection and dialogue among themselves, participants take part in a general class discussion facilitated by Tumblin's guiding questions (e.g., “Did you discover strengths you have but had forgotten?” or “Were there strengths you discovered that you can use in labor and birth?”).

Another strategy that provides instant results in generating empowerment is to show the 7-minute segment titled “Everyday Miracles,” in the Lamaze video Celebrate Birth (Injoy Videos & Lamaze International, 2000). Ask class participants what they saw in the video about birth that they have not viewed on television programs that depict births or heard from their friends. I have not had a class yet that has seen normal birth as it is presented in this amazing video and did not want the same support and options.

“COMFORT MEASURES FOR LABOR” (pp. 26–28)

Prior to their first pregnancy, expectant parents have usually experienced some physical pain in their lives. To facilitate a good discussion about comfort measures in labor, ask class members what pain they have experienced, which comfort measures (as outlined in the LPM article) they instinctively used or were instructed to use, and which comfort measures would have benefited them if they had used the techniques. Encourage class members to use the comfort measures during birth-preparation exercises. For example, while practicing contractions, they can employ comfort measures (e.g., aromatherapy, low lighting, music, massage, and choice of eye focus) that enhance increased attention to all the senses. Performing comfort measures in advance boosts information retention and enables expectant couples to more likely use these measures in the real birth situation.

“PAIN-RELIEF MEDICATIONS” (pp. 30–31)

The suggestions presented in “Minimizing Risks” are excellent resources for facilitating a discussion on how class participants think each suggestion will help diminish pain. Follow up with a discussion on whether the options will be available to them in their birth facility or with their care provider.

“LABOR AND BIRTHING POSITIONS” (pp. 32–34)

Do you remember the information you learned about adult ways of learning when you first became a Lamaze educator? Combining contraction practice with changing positions encourages expectant mothers to listen to their bodies during the actual birth situation and to follow their instincts to move around in order to facilitate the best positioning and descent of their babies. Doulas often feel they are present at the birth to give the mother permission to do what she already knows how to do when she is afraid to move forward with her instincts in the unfamiliar hospital setting. Practice is empowering. Many expectant parents contact Lamaze instructors because they want the actual practice of techniques that may help them in their births.

“SUPPORT FOR FATHERS: WHEN YOU'RE A LABOR PARTNER” (pp. 38–40) AND “DAD: IT'S ALL ABOUT YOU, TOO” (p. 72)

The title of Lamaze Parents magazine reflects the emphasis throughout the articles that the information is not only for mothers; rather, it is for parents. Although each of the articles includes material for fathers, two special sections offer fathers information particularly addressed to them. Expectant parents have long enjoyed having other parents who have recently given birth return to the class and tell the story of their birth. Class members can prepare for the visit by reading, “When You're A Labor Partner.” Additionally, you can offer the visiting dad the research section on page 72 and ask him to relate his feelings about the three statements.

“STRAIGHT TALK FOR NEW PARENTS” (pp. 46–48)

Many childbirth educators conclude their classes with a discussion of postpartum issues. The information in this section is a must-read for your class members. The section provides insight into the realities of postpartum emotional adaptation to parenthood and addresses the difficult issues of birth and parenting. All parents face these issues and they are rarely dealt with in-depth before birth. By facilitating discussion of the important issues brought forth in this article, you can open the door to examining various parenting styles (see Hotelling, 2004a) and emphasizing parents' need for support. Encourage participants to read this article before class. Then, ask how the information differs from societal expectations. Invite them to list their resources for support (e.g., friends, family, and work or school contacts) and to identify how each resource can provide support in parenting information, financial planning, child-care needs, transportation, and as an emotional sounding board. Your attention to this article may help couples avoid postpartum mood disorders or, at the very least, give them the permission they will need to seek help if they do encounter the condition.

“DOULA AT YOUR SIDE” (pp. 44–45)

Lamaze educators are not the only ones using LPM for a teaching aid. Kristin Lacy, CD (DONA), in Michigan writes:

During my journey as a doula, I find that the more information and education my client receives helps the both of us focus on something more important—putting all of the pieces together, role playing, and making a final draft of their desires and needs. You don't know what you don't know. That's why I use Lamaze Parents magazine to help my clients gather more detailed information about the pros and cons on various topics such as medical interventions, medications, birth, and parenting. Many call to thank me for providing them such great, informative, easy reading, or they mention it the next time we get together. The samples and pamphlets help a lot of women grasp just how much they need to buy or how much they already have. The articles are written in a way that is tailored to everyone. You feel a sense of warmth and commitment from the writers telling the positive aspects of pregnancy, birth, and parenting. Keep up the great work and know that your efforts are working. (K. Lacy, personal communication, August 19, 2005)

Ask expectant parents if they know why LPM devotes two pages to information about doulas. Then, guide the discussion to emphasize the importance of support during pregnancy, birth, postpartum, and life.

“SPECIAL SECTION: A WELCOMING WORLD FOR YOUR BABY” (pp. 51–62)

Pictures encourage familiarity, and new parents should be very familiar with baby-wearing techniques (maintaining closeness with one's baby by using a sling or front-pack), breastfeeding, and interpreting the messages the newborn sends to his/her parents. “The Newborn Family” is a section not to be glossed over. When parents are able to interpret their baby's signals, there is less frustration in parenting and a calmer family environment. Advance discussions of the first hour of life, states of consciousness, sibling acceptance, and communication with the newborn can save a family a lifetime of distress. Also, consider showing a short portion of the video, Amazing Talents of the Newborn (Johnson & Johnson, 1998), or loaning it to parents for an enjoyable homework assignment.

“PERSONALIZING POSTPARTUM” (pp. 66–68)

Planning for postpartum sometimes gets lost in planning for the birth. Encourage expectant parents to spend a few minutes filling out the resources list, and then present them with a list you have compiled of available local resources.

Cathy Holland, an LCCE educator in Michigan, uses LPM as the foundation text in her Lamaze classes:

There are other books and booklets for purchase to use in childbirth classes. However, the material in the Lamaze Parents magazine covers the same essential information at no additional cost. The LPM is easy to read, has great pictures and diagrams, and is a superior publication. Since I work at a hospital that services many who cannot pay for the class series, funds to purchase books are nonexistent. The way I use the LPM is to give each participant the publication as they arrive in the first class. My classes are very small, usually under five families. Rather than a lesson, I have them open the magazine and we start at the beginning and discuss or practice information in the articles. The discussions are enhanced with their personal experiences or questions and my knowledge. Parents bring the magazine to every class, and many will have read through the entire magazine before the second class. Parents say they learned a great deal of information from this publication. The reason I have stopped using other publications is that they do not embrace the WHO code that says advertising for artificial baby milk should not be given to families. In addition, the material in the LPM is the best. In my opinion, it is better than the publications that are for sale. (C. Holland, personal communication, August 18, 2005)

“There are other books and booklets for purchase to use in childbirth classes. However, the material in the Lamaze Parents magazine covers the same essential information at no additional cost.”

CONCLUSION

If the Lamaze Parents magazine is merely a giveaway in your classes, take some time for yourself, grab a cup of decaffeinated tea, put your feet up on that well-worn ottoman, and read through the incredibly empowering and informative gift Lamaze keeps giving you. The publication is meant to further the Lamaze vision: “A world of confident women choosing normal birth.” LPM can only speak to parents who are introduced to it by their trusted educators and doulas.

NOTE TO READERS

I have received several great ideas for teaching strategies from you, the readers, that I will share in the next “Tools for Teaching” column. The ideas do not fit into a single theme, so I will offer a potpourri of teaching tools. Space is available for a few more ideas, so please send your creative strategies (with permission to print) to me at 2112 Bretton Drive, Rochester Hills, Michigan 48309–2952.