Ep 50: Hospital Based vs Independent Childbirth Class (Pathways Article Review)

In today’s episode Doula Rachael and Dr. Shannon discuss the Pathways to Family Wellness article: Choosing a Birth Class: Hospital-Based vs. Independent Childbirth Education.  This article highlights how childbirth education is integral in preparing for giving birth but women sometimes feel overwhelmed by all the options available. This article offers a great comparison between hospital based classes and out-of-hospital based classes. 

We share how classes vary greatly based on approach, philosophies, and the resources they offer.  As always, our goal is to help provide information to support you in your decision making because, “Research shows that how women feel about their control over the decisions made during their births impacts how they reflect on their birth experiences, and when women come out of their births feeling like they were in control, they have an easier time integrating the experience into their postpartum reality and transitioning into the new role of mothering”.  Knowledge is power, and independent childbirth education classes are one knowledge tool to empower women as they prepare for birth. 

Pathways Article Link by Brittany Sharpe McCollum, C.D.(DONA)

Originally published at A Child Grows website

Dr. Shannon’s blog: Creating Your Birth Support Team

Previous Aligned Birth Podcast episodes mentioned:

Ep 3: Building Your Birth Support Team

Ep 18: What to Look For in a Childbirth Class

Ep 40: Lamaze 6 Healthy Birth Practices

If you like what you are hearing and you don’t want to miss our newest episodes, be sure and tap subscribe. Your suppor

Transcript

0:02

Hello and welcome to the Allied birth podcast. doula Rachel and Dr. Shannon, me. We are talking today again, we're having one of our wonderful conversations. And this one is based on an article that appears in. I like to say one of my favorite magazines, but I know Rachael really likes this magazine too, but it's pathways to family wellness. And we'll have the link to the article and everything but it's called choosing a birth class hospital based versus independent childbirth education. So we're gonna go through this article and highlight some of the things that stuck out to us. What we see in the office, some of the stuff that we wish birthing families knew some of the options that they wish wish they knew that they had and maybe give you some words that you may not even know because I will start this episode off with the fact that I did not when you know with both of my pregnancies, I did not know of there being an independent childbirth education option, versus a hospital based option because I was doing hospital births. So I'm excited to have this conversation today with Rachel because she is a childbirth educator as well as a doula and so I think it's important to have her on here too. The article is written by a doula as well Brittany sharp McCollum. But I think it's good to hit home some of these words, some of these definitions, and hopefully, you hear these things and like, oh my gosh, I didn't know that this was an option because now that I see this, I'm like, oh, man, I wish I had had this article when I was pregnant. So I had known that there were some of these classes out here. So I would love Rachel, I'm excited. You're here today, obviously, but I also want to start with like that. What are our hospital classes and what is our independent childbirth education and like, I've learned I'm excited to dive through this article

1:57

with you. Yes, me as well. And so childbirth education is near and dear to my heart. I am Lamaze certified and I became a doula first and then realized the education component was super important for me. I wanted to have that for my clients and I wanted to be able to share in a different way with expecting families. And me personally with my first I did take an out of hospital childbirth education class, and it blew our minds. It like led us on a journey that I don't know if we would have if we hadn't taken that out of hospital, childbirth education class. I'm forever thankful for that. And it definitely has shaped my approach to learning and teaching about childbirth. You know, this article believes and I also agree that childbirth education is integral and preparation. But women feel overwhelmed by all the options available out there. And so understanding the differences and sort of the two main categories there's hospital based childbirth education, and then there's independent med classes, and hospital based is exactly what it sounds right. It's offered and put on by the hospital where you're giving birth it sometimes it's free or it's low cost. Definitely these classes tend to have more people in them. They tend to focus on preparing women in their partners for what to expect in terms of policies and procedures in the hospital setting and tend to focus on the most common ways of birthing in that setting. So you may not get the full like physiological birth education, or what's normal, safe and healthy for most birthing people. You know, with the national statistics for epidural ranging from 60 to 80%. The vast majority of women who have epidurals not knowing that they have options other than birthing on their back and so the hospital doesn't tend to provide education on birthing without an epidural, like birthing and different pushing, you know, different positions and the different positions for pushing. I'm not saying there's not a hospital class out there like this. I'll say this that a lot of Lamaze certified childbirth educators do teach in hospitals. So if they are Lamaze certified and it is at a hospital I think that is a really probably good birthing class. However, it tends to still be taught by a usually a nurse from that hospital. They have certain things that they can teach about and not teach about. So you're still may not get the full experience as an independent class or as much hands on because they tend to be bigger groups and they don't do a lot of the hands on childbirth education stuff that like an independent class might do. So you know, definitely searching around figuring out does your hospital offer one you know, since we are in you know, we are in 2022? It's been COVID has been around for a couple years now. And that has drastically changed. The offerings like this like for hospital childbirth classes, so they're not as available as they used to be. So definitely check and see if your hospital has one or what's available in your area in regards to independent childbirth classes and check around and see which one feels like it might be a good fit for you. I I tell people I talk with if your hospital offers one and it's free or your OB practice offers one and it's free, take it because it's still going to inform you in a different way and then still take an independent childbirth education class, because that's going to be more comprehensive. And there are a lot of different childbirth education methods. out there and and classes and courses, especially these days online. So do your research. We have an episode I did back Gosh, Episode 18. And it kind of breaks down some of those different methods and what to look for in a childbirth education class if you're like overwhelmed by all the options out there so I definitely encourage doing some research and checking that out and figure out what class meets your like philosophy and your needs and your preferences for your birth and then based on where you're giving birth, like you're giving birth at home or at the hospital or at a birth center, like pick a class that kind of meets those needs. And that's a really long answer to your question.

6:21

Like I love it. No, I'm like keep going girl keep going. Because i i Too in the office like I often share, you know, I What do I share? I share that I did not have a goal with my verse and I did not take independent childbirth education classes. And that is why I mentioned it and feel so passionately about it for my families because I know the potential that is there that you know, you can feel so supported and you can feel so informed. And so I love that you mentioned that. Um, it doesn't have to be an either or. So you don't have to be I mean, I guess in certain circumstances, maybe monetarily it can be but you know, you can do that hospital class, because maybe that does give you that sense of peace. You see the room you know you do the hospital tour or something along those lines and you previous Yes, the nurses you know like that's a motorized like oh my god like the hospital ibert That was massive. And you know, I'm like, I don't know where this is and where do you go here? You know, this could be an option in the room. You could find out I mean, hopefully you know beforehand but you know, as far as like water birth or when I mean water birth wasn't even in my vernacular when I was pregnant. So, so sad. So like, it's, that's, you may not get that in that hospital class, but you can still get information that is important, but maybe, I guess the type of information that I want my families to have is kind of reflected in the quote here from the article, because it says research shows that how women feel about their control over the decisions made during their birth impacts how they reflect on their birth experiences. And when women come out of their births feeling like they were in control, they have an easier time integrating the experience into their postpartum reality and transitioning into the new role of mothering. Yes, I know that that childbirth education does that because it's, you know, because I have those issues with with my birth and that kind of postpartum experience. So it can add that layer of that added information you can get so much more information in those independent lead classes so definitely doesn't come across as like oh, it has to be either or. But I do want people to know those words your independent childhood education because I did not Yeah, well,

8:41

and some people think that that out of hospital or independent birth classes only focus on giving birth, like unmedicated or quote unquote, natural which I don't love that term, because birth is birth and I think it's all natural. But I think there's like unmedicated versus medicated and some people think, Oh, well, I'm not. I want an epidural. So I'm going to give birth I'm going to go the hospital base class because that's they're gonna focus on that and that's, you know, out of hospital classes are only for unmedicated births and that is just not the not all of the truth. So while they do have info on ways to cope during labor, so out of hospital birthing classes, independent birthing classes definitely have an emphasis on different ways to cope with the intensity of labor. They also offer so much more so they help you explore options, encourage you to find your voice and use your voice, how to use it, how to advocate for yourself, and it also helps empower partners to advocate and be active participants in the process, as well. And that was part of the article that I was like, Yes, that's it and that's tagging on to what you just said as far as like, it's not necessarily the mode of what you give birth. Definitely that plays into it, but it's how you feel during the process and part of how you feel is being seen as the autonomous birthing person that you are. And so having the tools to be able to tap into that and learn the information about the normal physiological process of giving birth, how to ask questions, how to view yourself as the like person in charge of this birth, not the provider. Those tools are what you get in an independent childbirth education class, and that is what can make your birthing experience exponentially better not learning to do birth a certain way.

10:27

Exactly. It doesn't have to be learning Yeah, to do it that certain way. But it's exploring those options and feeling comfortable with those decisions. And I feel too it's it can even open your mind and world to things that give that you may not have even known or considered I mean, I still go back to the interview I did with the Zoya who's a local doula, a doula view, and she's working with a mom who has an epidural and they don't want her to move, but Latoya is trying to advocate for her client and kind of saying why can't we do this? What are the benefits? What are the risks and looking at like, okay, we can do something here. We just it was a very minimal risk as to why the mom couldn't move and so what hospital even the article it says What hospital based classes offer Bill Debold is the multitude of physicians and choices that are still available to women. After accepting pain medication? Yes. And it's not that they it's, I don't know. It's not that they don't want you to know, you know what I mean? It's just there's a lot of information. They have a lot to cover, and they are approaching things from that. I it's more of that risk management. You know, it's more, it's more of that medically managed birthing process. Maybe, maybe that's part of the difference there. I don't know. Yes, yes. And when I need to deadbolts like why the hospitals are doing this. It's not like I don't know, but

11:55

it's understanding where they're coming from and what they see on a regular basis. So again, like 60 to 80% of people choose to birth with an epidural. And so that's what most nurses are the type of birth they're helping support and there's nothing wrong with that. But if that's what they're used to, then that's what they're they're going to teach on. That's the majority of what they see. Nothing wrong with that, but knowing that there are are ways to labor with an epidural or with pain medication that's still active and it still helps facilitate labor progress and it still keeps you centered and grounded and it still keeps you in the driver's seat versus you know, just kind of submitting and being, you know, part of the, the, you know,

12:37

them just telling you what the right and so learning your team

12:43

Yeah, yeah, so learning about those is just helpful. So and this is why I chose Lamaze is because it's not a particular like method. It's not saying, Okay, we're going to avoid pain or we're not gonna get pain medication, or we're gonna have a euphoric birth. It's just, it helps you navigate the birthing process, which is unpredictable. It is nonlinear. And it says like, how do we protect these healthy birth practices? And even if you need an epidural or choose an epidural, and I view an epidural as a tool when used judiciously, I don't see an epidural as bad or wrong and that's the same way I feel about inductions. You know, there are a lot of people out there who are like Oh, inductions are the worst and they can be but they can also be pretty great and they are sometimes necessary. So if my client or my student needs an induction, I want them to know that they're having an induction because they need it because they've learned about actual reasons for needing an induction they've learned how to ask their provider questions to determine if that induction is truly necessary and to formulate a plan that is unique to their needs and where they're at and know their medical history and have a gentle induction or or whatever that helps them. Again, stay in the driver's seat, stay the decision maker and then avoid those downline interventions. So how do you protect the rest of those healthy birth practices even if you do need some medical intervention, because I'm not going to sit here and say medical intervention is bad or wrong. We need it. Sometimes it is absolutely life saving. So when we view it in that way, instead of fearing it, we can learn how to use it so that it helps us and doesn't hurt us and we don't fear it. So we're not going into saying absolutely no way. Am I going to get anything at saying okay, well, if I need it, I've learned about it. And I know how to how to labor with it. If I do have to get an induction or an epidural or even if I end up meeting a Syrian and so many of our mamas. That's one of their greatest fears is this is a cesarean and in our country where it's 30 plus percent cesarean rate. That's a real concern, when only about 10 to 15% of them truly need a cesarean. But but we don't like to say, Well, you're not going to have a cesarean if you do X, Y and Z. We say okay, we're going to set you up for success, childbirth, education, learn about the normal physiological process of birth, learn about coping techniques and communication. And then if you do need this, this area and here's are some things to consider to help you have the best cesarean possible so that you feel good on the other side of it. And so that is the goal and that's why independent childbirth education is is so important because it helps kind of and and in my view, my very biased lens is everything I just said but there are methods out there that are very focused on like, very particular like methods of coping and so if that aligns with you do it. I just encourage that sort of well rounded education when it comes to childbirth.

15:46

I mean, Dr. Mike, that was so good, because I was like nodding the whole time. Um, but that's what that education can give you instead of I think, really, when we have that knowledge, it can dispel some of the fear that is inherently associated with birth as far as because of the unknown, you know, and that unpredictable nature of it. So how best do we do that? And that's, I mean, everything you just said was so wonderful. And that's why in I think we even did an episode we did like the creating your birth support team. That's why number four on there, in that for part, you know, birth support teams, is educators. Right, really specifically looking at childbirth educators. So we have that episode. I remember when it's like three, I think that's one of the early early ones. And then I think I rebroadcasted that one too because I think it was one of my favorites. So good. And then I even have a blog too, but and no, it can be overwhelming. But I would just implore you to a little bit at a time maybe research one birthing method or you know coping mechanism or scent. Or look at one class at a time or something and find like what you said find what aligns with you and try to take it bit by bit instead of being like, oh my gosh, there's so many classes. There's so many options. I don't know. Right? So, I mean, that's I feel like that's the hard part with it too. Because there are a lot of options.

17:25

There are and especially in today's world, it's you start Googling or searching around and that can make it very overwhelming. But I do encourage listen to episode 18. I sort of break down some of the more popular methods and types of independent childbirth education classes. So you know, you can kind of give a get a little taste there and kind of like okay, that sounds good to me. I'm gonna go check that out. If you want to learn more about the Lamaze healthy birth practices, which I I think, is obviously I that's what I teach and I think that's a good way to go. If you want to learn more about that. Then listen to episode 40. And even if you don't choose a Lamaze childbirth class, it's still these. I go over the six healthy birth practices in that in that episode, and that's the framework for the Lamaze class. And so even if you don't choose a Lamaze class, you still kind of are learning about these like healthy birth practices. And so that can be helpful for you on your journey, too. But yeah, we're all about choose what aligns with you do a little bit of research try not to try easier said than done to not let the overwhelm you know, stop you from moving forward. And if the hospital class is all what's available, and what you can afford, and they're offering it take it like this is not to knock those classes because they can be helpful in some way. So if that's what you got in your house, well, um, I have a wonderful childbirth education program. I mean, I think they vary again, every there's some variations of and you can always inquire and ask about like what they cover and see if that feels like that's a good fit for you. You know, and learning about the background of your instructor. is important too. And this article talks about that as well. Like, who are they certified with? And does that organization align with you? So there's, like these organizations who certify instructors and so you want to find an instructor that's good for you, but you kind of want that overarching organization to also align with you. And then the hospital based class might have a variety of instructors that rotate teachers and not just have one person so you may not know who you're going to get. It's usually a hospital employee. Typically, that teaches them so sort of checking into that background of the instructor. I appreciated how this article kind of reminded us to do that. Yeah.

19:49

And even in looking at the classes, we're looking at how you feel comfortable, to learn and to listen and to ask questions like what environment do you feel comfortable in because you know, again, with COVID We've had a lot more things going virtual so maybe you do feel more comfortable virtual and sometimes those classes are they do put a cap on it, you know, so that there are room for question answer, is this something or do you want that in person? Can your spouse your partner, be there with you, you know, look at all of those little things, who do you want there? How many classes are there? How long do they last? You know, it's really looking at all the logistics of those because there's going to be there's going to be different different options there but also looking at where how you feel comfortable learning what Yes, that's

20:43

right. And I think our current state, I think you could probably find some I think some are back to in person like if you really want that in person because you love being in like presence of people and you want that hands on experience. Did I think you could probably find an in person class or if you're like nope, I want to do from the comfort of my home, either live or I want to do pre recorded because I want to do it on my own time. Like there is all of the above. So again, aligning with what you feel most comfortable because when you feel comfortable, you're gonna learn you're gonna be able to kind of absorb that information more easily

21:20

attain it, you know, that's the big thing too, because you do want this information to be rotatable for you when you are in labor, you know, and so that you can actually pull on those sources. So yes, you know, hopefully your support person there can help to,

21:37

yes, loved this also talked about the community that comes from childbirth education classes. It says many expectant parents even form lasting relationships with their childbirth educators, staying in touch throughout pregnancy and reaching out to share news and seek resources in additional classes after their baby arrives. And so it's just another another layer of support that you get, as well as like the people you meet in that class. If it's not a private class. You kind of meet people who are in similar life stages and you're you're instantly bonded. And so sometimes relationships can form in those settings too, which are awesome.

22:10

Yeah. I recently have dealt with some moms that so I guess you can have you know, hospital based childbirth education classes, and then some OB opposites and practices will offer one as well. And then I guess you have the option for like those independent ones. Well, some OB offices in our area are still aren't offering classes or they may not even go back to offering classes because I guess just with the kind of the culture and how things have worked out, those virtual options have worked better for them. So there there may be less, you know, class options in that sense. So maybe it can just boil down to okay, we need to look at the hospital or we need to look at you know, doing the independent one as well. But when I hear my mom say that I do I do highly recommend and like well, taking a childbirth education classes important, you know, and to give you that foundation and that backbone. Yeah, but it's kind of interesting to see how how things have changed a little bit.

23:18

Yeah, no, and that's right. And yeah, just seeing what's available in your area and also there is a there's some studies about independent childbirth education classes, having like, a more positive impact on the birthing person and their outcomes, you know, for giving birth and so that's really good to know too is that taking that sort of independent out of the hospital learning about the actual like comprehensive childbirth education class has kind of better outcomes than if you only took the hospital based class or didn't take one at all.

23:53

And the last sentence in the article here I think is really good. This is an independent childbirth class provides the restorative balance of knowledge, tools, empowerment and support that helps to ease the transition from pregnancy into labor, birth and the postpartum period. Yes, and I know so hopefully, you've definitely just something to consider because I'm wondering too, if you're like me, and this this might be the first time in your pregnancy that you're hearing Oh, independent childbirth education class, because if this is the first time the goal met, just want these words, to be heard and that people know that they have these

24:32

options out there. That's the goal, sister I think we I really enjoyed that article.

24:37

I know it's really good. Well link it and it's actually I linked it two times because at the end of the pathways article, it does mention that it's originally published at a child bros.com blog website. So we've linked both of those again, this is from that pathways article. Pathways to family wellness is a chiropractic based magazine, but has lots of wonderful articles in there. They usually have some from holistic health care providers, midwives, doulas and offers lots of good education and so definitely we'll link to those articles. And you know, hopefully this helps you learn a little bit more about the options that are out there. Be sure to check out all the other episodes that we've linked here and then we'll link all of those there. And then I'll put my building a birth support team blog as well at the link in the show notes. And be sure to share this with any expectant families that you know, so that you can share the knowledge of independent childbirth education class options for them so that they can have their informed pregnancy birth, labor and postpartum time period. If you have enjoyed listening to the show, and all of our episodes love ratings and reviews that helps us reach more people helps us keep doing what we're doing. And thank you so much for listening today.

29:35

Happy belated birthday are chapters on no ideas at all. She before he or she or she

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