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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