Using The Official Lamaze Guide in Childbirth Education Classes

Abstract

Normal birth has long been promoted by Lamaze International in its mission and vision statements and by the Lamaze Institute for Normal Birth. The Official Lamaze Guide: Giving Birth with Confidence, a book by Judith Lothian and Charlotte DeVries, can be used by birth educators to alter the focus from learning what to expect when one fears the worst to empowering women to understand that birth is usually a healthy, normal process. In this column, the author suggests ways in which childbirth educators can use The Official Lamaze Guide in their classes.

Almost 10 years ago, Lamaze International commissioned two authors to create the official Lamaze book. Judith Lothian and Charlotte DeVries stepped up to the plate and were selected as coauthors because of their history with Lamaze, their expertise in normal birth, and their abilities to communicate the message of normal birth to families. With support from Lamaze, they worked long and hard to find a publisher willing to produce a book that was so different from others in the field. Expectations for The Official Lamaze Guide were high, and these expectations have been met and surpassed. The Lamaze Guide, as it will be referred to from here on, offers an empowering description of pregnancy and birth as a family event rather than a pathological one, as many today believe. Lothian and DeVries produced the book on behalf of Lamaze International so that educators will have the tools they need for instructing women and families in normal birth and for assuring that women, regardless of whether they attend childbirth classes, will be able to make wise decisions.

A UNIQUE TEACHING TOOL

You may wonder how to use The Lamaze Guide with your classes because it doesn't look like the typical class book. It doesn't include lists of medications or medical interventions, and it doesn't present anatomical illustrations or definitions. You may think this is just a great book that tells the story of normal birth. What you will first need to do in using this book with your classes is to reframe your own thinking about what parents need to achieve in the short amount of time they have with you. Are we preparing them with all the medical information they will need to create a protective birth plan and negotiate with their care providers? Are we preparing them for the realities of birth in the location they may or may not have chosen? The focus of Lamaze, based on the evidence, is to teach women to trust their abilities to give birth without needless medical interventions. Birth is a physiological process women can trust, not a pathophysiological one they need to fear. Today, we're blessed with technology that saves mothers' and babies' lives. Yet, we've abused that same technology and displaced the mother in her own birth.

The Lamaze Guide offers an empowering description of pregnancy and birth as a family event.

In The Lamaze Guide, women's stories are shared to empower other women in their own experiences.

The Lamaze Guide illustrates the organization's changes over the past decade or longer. During Lamaze's beginnings in the United States, childbirth professionals and expectant mothers needed structure and a method to return into awareness in birth, an awareness that was lost with amnesic drugs (“Twilight Sleep”) and other interventions that allowed women to survive the new hospital births where they were separated from all support systems. As the evidence evolved, so did Lamaze. Gone were the previous assumptions that the coach directed the birth, that specific breathing techniques led to a successful outcome, and that there is no advantage to pain (Lothian & DeVries, 2005). The Lamaze Philosophy of Birth and the Lamaze Parenting Philosophy were written to reflect changes in Lamaze and are based on evidence that the birth environment profoundly affects labor progress, that mothers and babies should remain together immediately following birth, and that the ultimate goal is for every woman to give birth with confidence.

The purpose of this column is to provide childbirth educators with unique teaching tools to make it easier to use The Lamaze Guide in classes. We're all unique in the ways we teach; in using The Lamaze Guide, you'll develop your own ways of sharing this empowering book with your class participants.

Early Pregnancy Classes

The first four chapters of The Lamaze Guide are excellent for use in early pregnancy classes. This is a time when some of the biggest decisions are being made based on the current culture of birth found in friends' and relatives' stories and in the media's accounts. This is typically the time when mothers decide how they plan to feed their infant. Early discussion and introduction to evidence-based information can mean so much to them in birth and for the rest of their lives. Educate them about their rights with the Childbirth Connections' (formerly Maternity Center Association) Rights of Childbearing Women (Lothian & DeVries, 2005, pp. 253–257). Introduce them to the ways doulas can contribute to their births (pp. 275–281). Explore with them the characteristics of a mother-friendly environment with the Mother-Friendly Childbirth™ Initiative (pp. 243–252).

Women's Stories

Early pregnancy is also a time when mothers and fathers can be encouraged to start their own birth stories by journaling. In The Lamaze Guide, women's stories are shared to empower other women in their own experiences. Storytelling was once the mode of passing history from one generation to the next. It is a valuable learning tool. Mothers and fathers can be given the assignment of interviewing women of all ages about their birth experiences. Questions the parents might ask other women can be found on pages 24 and 40 in The Lamaze Guide.

The suggested questions are actually useful anytime in learning situations when parents seek information about birth and parenting. Depending on the time you have to spend with parents—even in a clinical encounter with limited one-on-one time—parents can be encouraged to gather birth stories and to go online to chat with The Lamaze Guide authors in their blog (http://birthwithconfidence.blogs.lamaze.org/). Some of the following suggestions might be left for third trimester classes.

Care Practices

Chapter 8 in The Lamaze Guide, “Keeping Birth Normal,” is an extended discussion on each of the six care practices for normal birth, which were based on the World Health Organization's Bologna scale (Chalmers & Porter, 2001). The World Health Organization listed four care practices that promote, support, and protect normal birth. Lamaze added two more. Parents can be assigned each of the care practices to read for the next class and, then, encouraged to facilitate the discussion about that care practice. Some thoughts to include might be:

• Have you heard any birth stories where the parents used the information in this care practice?

• Have you seen this care practice in the television births you've watched?

• Did your mothers, aunts, sisters, or other family members use the information in this care practice to make their births better? Where did they learn this information?

• How would the information in this care practice benefit you at your birth?

The six care practices are, in essence, a measuring tool for normal birth as well as a guideline for caregivers to practice normal birth. The care practices can be used to measure births the women have already experienced, the births of friends or family they have assisted with, the births they see on television, the birth stories they hear from their friends and coworkers, and the births they learn about in Lamaze class. When you've evaluated several births according to the six care practices, women will internalize these practices and remember the key points as they make decisions about their own births.

Conquering Fear

One way to help people conquer their fears is to encourage them to name the fear and, then, problem-solve. This can be done anonymously in class by having class members write down their fears on a slip of paper. You can then collect these slips of paper and redistribute them among the class participants. When a parent reads someone else's fear, he or she can offer suggestions for the anonymous writer. Oftentimes, more than one class member acknowledges they have had the same thoughts.

Lothian and DeVries offer an exercise that mothers can do everyday to connect with themselves and check in with their own feelings and the growing life inside them (2005, pp. 33–35). Aside from stress relief, mothers enjoy time to “pause, to step away from your crowded agenda and to surrender to the delight and mystery of what is growing within you” (p. 35).

Healthy Lifestyle Changes

Women are consciously or unconsciously in tune with their baby from the moment they feel they might be pregnant. They make decisions based on the possible effects on their baby, consequently changing lifestyle practices that might harm their baby to ones that promote healthy growth and development. They rub their growing bellies, avoid smoke-filled rooms, and pay attention to the food they eat. Question them in class and ask what changes they have made. Then, refer them to pages 36–38 in The Lamaze Guide and examine whether their changes are similar to those suggested in the book. A follow-up discussion can be about changes they would like to make in the future for healthy babies, healthy mothers, and healthy families.

Compared with other class books, a unique feature in The Lamaze Guide is the focus on connecting parents with their unborn and newborn children.

The Baby!

Compared with other class books, a unique feature in The Lamaze Guide is the focus on connecting parents with their unborn and newborn children. Chapters 12 and 13 are empowering in their presentation of both emotional attachment and decisions about physical care of the babies. Parents are always amazed and delighted that their newborns will have highly developed senses and means of communication. Promoting early bonding leads to securely attached babies and parents who will move sun and earth to love and protect their children.

A PRECIOUS GIFT

Childbirth educators now have a precious gift to offer parents-to-be. The Lamaze Guide was meant to send parents the evidence-based message that birth is normal. For educators to use this gift wisely, we must first agree with the premise that birth is a normal and natural part of life. Then, we must examine our current teaching tools to see if we're contributing to the fear-based culture that says that the only time birth is normal is in retrospect. In some instances, we will have to reframe our thinking, but the impact normal birth has for our society is far more beneficial than the current norm. We might begin to see a shift in the language toward mother-centered birth. Families would be securely attached because of the feelings of self-confidence and accomplishment they felt at their children's births. Fear would be replaced with knowledge, and our society would be more patient. Use the gift wisely and look forward to enchanting births.