Nikki... I totally agree with you re: hospital-based childbirth classes.  It's the primary reason why I teach Bradley classes in my own living room even when it means my students have to stretch out side by side like kids in camp when they're doing exercises or learning new relaxation techniques.  It would be lovely to have a larger venue to accommodate my usually full classes (limited to 8 couples by the AAHCC), but it's lovelier still to be beholden to no one.  My CS rate is around 10% and mostly limited to multiple births and breech babies so I know my classes are pretty effective.  ;-)  Heck, if the careproviders would allow primips to have twins and breech babies vaginally, my CS rate would be minuscule!  
   
  Cee

Nikki Lee <[log in to unmask]> wrote:
  Dear Friends:

Laura makes an excellent point. One can say that childbirth classes in the 
US are ineffectual, as 1 in 3 women have their babies cut out of them. 

When the childbirth revolution started, in the late 1950s and early 1960s 
(in the US)
women taught themselves. Classes were held in basements and living rooms; 
there was a passion and vitality in this grassroots movement that ignited the 
nation. I heard stories of fathers handcuffing themselves to their mates to 
ensure their presence in the delivery room. 

A problem came when hospitals started sponsoring childbirth 
classes........then the passion was removed, and other people (such as anesthesiologists) got 
to have a say in what was taught. A major factor in this change was medicine 
going corporate, where profit drives the care rather than health. In my 
personal world, that shift happened in January 1989 in Philadelphia, when Booth 
Maternity Hospital closed, the first casualty in the changing paradigm.

Childbirth classes now are places where folks learn how to be patients in 
the hospital. Education is now used to suppress, rather than to elevate. (Paolo 
Freire said this best). And we see the result in technologically driven 
birth, high rates of surgery, and increased supplementation.

There are pockets of hope and passion left with Birthing from Within and 
Hypnobirthing (and other styles) out-of-hospital classes. 

Hospital childbirth classes are not designed to give any sort of power to 
women; most of the major films used start with the disclaimer "This film is not 
meant to substitute for medical advice." Hospital childbirth educators have 
to toe the line, else physicians won't send clients to the classes and 
childbirth education programs will fold for lack of income.

Giving women incentives to come to class is a symptom of how useless the 
classes are........as a whole, for our nation. (Please, as a long-time 
childbirth educator, I know the potential and recognize that there awesome classes out 
there making a difference for some women. The problem is that these classes 
are generally private and accessible only to those already open to other 
ideas, and having the money to pay for the classes.)

I pray that labor doulas stay independent, else they will be coopted to 
soothe women into accepting the technology by hospital administered programs.

I believe that currently childbirth classes are generally a poor substitute 
for community; one can't learn about birth in a 1 or 4 classes at the end of 
a pregnancy. One learns about birth by what is shown on TV, what one hears 
from one's girlfriends, and experience.

This all lays the foundation for breastfeeding; battered women (and women 
with technologically driven births have been battered) can't be proactive and 
eager to meet and nurse their babies. Injured babies shut down and don't want 
to feed, particularly if they are iatrogenically premature. (The March of 
Dimes in 2005 said that 25% of all prematurity in the US is the result of medical 
intervention; the CDC in 2005 said that " Although the upswing in multiple 
births has had an important influence on recent trends in preterm birth rates, 
shorter gestations have also risen among singleton deliveries.") Look at the 
Cochrane Collaborative, and you will discover that there is no routine 
hospital labor practice that has any supporting evidence behind it.

I don't know why a healthy woman would choose a hospital as a place to 
deliver any more. The crowding in my city (some hospitals are delivering 1,000 
more babies a year than they are equipped to handle, leading to situations where 
women have labored in the hallway) plus MRSA plus C. Difficile plus the 1 in 
3 chance of surgery make hospitals very scary places. It used to be if a 
woman went to the hospital too early in labor, she was sent home. No 
more............now she is kept and induced, even if she isn't in active labor.

warmly,


u

Nikki Lee RN, MS, Mother of 2, IBCLC, CCE, CIMI
_www.breastfeedingalwaysbest.com_ (http://www.breastfeedingalwaysbest.com/) 
www.myspace/AdonicaLee



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