Parenting - Prenatal to preschool/Parenting_PrenatalToPreschool.bin/dp/0042/00427.txt

Text File | 1993-06-14 | 14KB | 236 lines

$Unique_ID{PAR00427}
$Pretitle{}
$Title{Pregnancy:  The Second Trimester:  Planning and Preparation}
$Subtitle{}
$Author{
Editors of Consumer Guide
Ellis, Jeffrey W
Ellis, Maria}
$Subject{Planning Preparation Childbirth Classes discomfort pain Lamaze Method
labor psychoprophylaxis delivery relax breathing effleurage pain medication
Bradley relaxation exercise exercises Dick-Read fear-tension-pain cycle
breathing tension fear fears natural childbirth Kitzinger psychosexual
preparations Leboyer Technique birth without violence instructor instructors
self-care newborn care breast-feeding bottle-feeding labor pain breathe
massage massages visualization focus home-birth refresher cesarean-section
single mother lesbian lesbians language barrier parents impaired hearing
vision teen teens teenage adoption VBAC sibling grandparent adoptive}
$Log{}

Miracle of Birth


The Second Trimester:  Planning and Preparation


Childbirth Classes


     The purpose of childbirth classes is to prepare future parents to deal
positively with the entire experience of pregnancy, labor, and birth.  Of
course, every pregnancy is unique, and no one can predict exactly what will
happen and how you will feel during your pregnancy and delivery.  But
childbirth classes can give you and your husband an idea of what to expect
when you're expecting.  They can help dispel myths, ease fears, and give you
the knowledge and confidence that can help make childbirth a fulfilling
experience for both of you.
     Childbirth classes will teach you about the process of pregnancy, labor,
and delivery.  You will also be taught techniques to help you relax and help
you deal with discomfort and pain.  The more you learn about pregnancy and
childbirth, the less you will fear.
     Childbirth classes are available in nearly every community.  Some are
sponsored by hospitals or institutions, while others are taught privately by
certified childbirth educators.  These classes are usually inexpensive or
free.
     Childbirth preparation classes are usually attended during the third
trimester.  Most meet in the evening or on weekends, making it more convenient
for you and your spouse to attend together.
     Several different methods of childbirth preparation are currently
popular in the United States.  Each of these takes a slightly different
approach to reducing the discomfort and pain of labor and delivery.  Some
childbirth classes teach only one method.  Others provide a broader, more
individualized kind of preparation, drawing from each of several different
methods.  The goal of these broader classes is to enable women and their
partners to discover their own style for labor.
     Basic to all methods of childbirth preparation is the concept that the
discomfort and pain of childbirth are real, but that they can be minimized
through psychological preparation.  Childbirth preparation methods will not
eliminate pain; rather, they teach you why pain occurs and demonstrate
techniques to help you cope with it.
     The following are the most commonly taught methods of childbirth
preparation.  At the end of this section, you will find tips for choosing the
class that's right for you.

Lamaze Method

     The Lamaze method of childbirth preparation is the most popular and
widely used method in the United States today.  This method is named after
French physician Fernand Lamaze, who believed that by concentrating on a
specific distracting stimulus during labor (such as staring at a particular
spot or breathing in a controlled fashion) a pregnant woman can "block" the
transmission of pain impulses from the uterus to the brain.
     This method, also called "psychoprophylaxis," involves training or
conditioning a woman to respond to her contractions by relaxing.  Your "labor
coach" (the individual you choose to help you through labor and delivery) is
an important part of the Lamaze method.  During the classes, he or she will be
trained to help you consciously relax and help you use specific breathing
patterns to take your mind off your contractions.
     The Lamaze method also involves certain physical means of decreasing
painful sensations, such as light massage (called effleurage) on the surface
of your abdomen and back.
     Since training and conditioning form the basis of the Lamaze method, it
is necessary for you and your "coach" to spend time every day practicing the
techniques that you learn in class.  The more you practice, the more effective
the method will become.  Eventually, you should automatically respond to a
certain stimulus with specific breathing patterns and relaxation.
     It should be emphasized that the Lamaze method is not the same as natural
childbirth--that is, childbirth without pain medication.  Not all women who
use the Lamaze method will have the same type of delivery experience.  Many
women, for reasons of personal preference or medical necessity, will use some
form of pain medication or anesthesia during their labor and delivery.  Lamaze
training is intended to help you cope with pain, not act as a substitute when
pain medication is necessary.  Accepting pain medication does not mean that
you are a failure.

Bradley Method

     Another common method of childbirth preparation is the Bradley method,
named after obstetrician Robert Bradley.  Unlike Lamaze, the Bradley method
emphasizes true natural childbirth--that is, giving birth without using any
drugs.
     The Bradley method stresses working in harmony with the body.  It
prepares the woman to experience the intensity, and pleasure of birth by using
deep relaxation techniques and by tuning in to her body's sensations instead
of using certain breathing patterns to distract her from her labor pains.
     Certain fitness exercises are also part of the Bradley method.  For
example, pelvic rocking exercises (see The Second Trimester, For You and Your
Baby, Childbirth Exercises), are used to reduce pressure in the pelvic area
and increase the flexibility of the lower back.
     The Bradley method is often referred to as "husband-coached childbirth,"
since the father plays such a major role in maintaining the mother's deep
relaxation.  The father is asked to observe the mother's breathing patterns as
she sleeps so that he can help her to breathe in a similar relaxed fashion
during labor.
     Childbirth educators who teach the Bradley method believe that true
natural childbirth can take place if the parents are properly prepared.  This
method is especially well suited for couples who intend to give birth at home
or in a free-standing birthing center.

Dick-Read Method

     The Dick-Read method of childbirth preparation evolved from the teachings
of Grantly Dick-Read, an English obstetrician.  He identified what is called
the fear-tension-pain cycle, emphasizing that fear causes tension, which leads
to unnecessary pain.  Because this pain causes further fear and tension, the
cycle repeats itself.
     From this observation, Dr. Dick-Read devised a method of childbirth
preparation that attempts to break the fear-tension-pain cycle.  This
method involves teaching the mother why pain occurs in order to help relieve
her fears.  It also involves breathing exercises, which are designed to help
the mother release tension during labor, and certain physical exercises, which
help prepare her muscles and joints for the process of labor.
     Today, childbirth educators who teach the Dick-Read method emphasize that
the pregnant woman should work in harmony with labor; she should relax and
breathe in response to her body's demands, instead of according to a set
schedule.
     Since the Dick-Read method prepares women for unmedicated or natural
childbirth, it is also well suited for those planning a home birth or those
using a birthing center.

Kitzinger Method

     Another method of childbirth preparation is the Kitzinger method,
developed by English anthropologist Sheila Kitzinger.  This form of childbirth
preparation is not generally taught as a separate method, but rather is
incorporated into the teachings of childbirth educators who primarily teach
other formal methods.
     Frequently called "psychosexual preparation," this method teaches that
childbirth is part of the wide spectrum of sexuality in a woman's life.
Exercises are therefore described in terms of normal processes of the body,
and emphasis is placed on working in harmony with these processes.
     Another major part of the Kitzinger method is the use of a variety of
techniques for relaxation, including gentle massage and mental imagery to
develop awareness of the body.

Leboyer Technique

     Though not a method of childbirth preparation, the Leboyer concept of
"birth without violence" is commonly discussed in childbirth classes.
     Dr. Leboyer, a French obstetrician, developed the concept of "gentle"
delivery, which is designed to make birth less traumatic for the baby.  He
advocated a warm, quiet room with dim lights for the birth and a warm bath
for the baby shortly after delivery.
     In this way, he felt that the baby could be helped into a gentle and calm
transition from life in the uterus to life outside the mother's body.

Choosing a Class

     Childbirth classes are designed to make childbirth a more fulfilling
experience for you and your husband, so it pays to select the class carefully.
You'll want to find a method (or a mix of methods), a class schedule, and an
instructor that you feel comfortable with.  Chances are, the more effort you
put into finding a class that's right for you, the more you will get out of it
and the better prepared you will be for childbirth.
     You might want to begin your search by asking for suggestions from your
doctor, from friends who have taken classes, or from your hospital's maternity
department.  Once you have a list of possibilities, call and ask the
instructors to describe their classes and their credentials.  You can often
learn a lot in a brief phone conversation.  It may even be possible to have an
interview with the instructor before registering for the class.
     Ask about the instructor's qualifications.  Is the instructor an employee
of a hospital or physicians' group?  Does the instructor belong to any local
or national organizations of childbirth educators?
     Some organizations require their instructors to have a medical
background, such as nursing or physical therapy.  Others require a college
degree in a related field, such as psychology, social work, or education.
Some have no special schooling requirements.
     Most instructors also receive training in childbirth education.  Training
may be minimal (for example, the instructor may have been required only to
observe a series of classes), or it maybe quite rigorous, leading to
certification by one of the national or international childbirth
organizations.  The certification process for these large organizations
usually requires classroom sessions or workshops, written work, examinations,
observations of childbirth classes, attendance at births, and teaching under
supervision.
     Ask about the method of childbirth preparation taught in the class.  Is
it Lamaze, Bradley, Dick-Read, Kitzinger, or a combination of these?  Ask,
too, about the topics that are covered.  Possible topics include self-care in
pregnancy, preparation for normal and complicated childbirth, newborn care,
breast-feeding and bottle-feeding, and the beginnings of parenthood.  You
should also find out how much time is actually spent on learning and
practicing techniques for coping with labor pain, such as relaxation,
breathing patterns, massage techniques, and methods of visualization and
focus.
     Ask how many actual class sessions are involved.  Some classes consist of
a series of four sessions, while others consist of as many as 12 meetings.
Classes generally meet once a week and may last from one to three hours each
time.
     How large are the classes?  Classes may range in size from private
sessions for one or two couples to large classes for 40 to 50 couples.  A
small, intimate class may be important to you, or you may prefer a more
diverse, larger group.  If the group is large, does the instructor have one or
more trained assistants who can provide more personal contact with the
students?  Is personal contact with the instructor by phone or by appointment
available?
     In many communities, specialized classes are also available.
Early-pregnancy classes, for example, are generally attended during the first
trimester of pregnancy.  These sessions cover proper nutrition and exercise,
common discomforts of pregnancy and ways to cope with them, development of the
baby, and changes that occur in the woman's body in response to pregnancy.
     Other specialized classes that may be available in your area include:
home-birth classes; refresher classes, for those who had childbirth classes
during a previous pregnancy; cesarean-section preparation classes, for those
who know that they will have a cesarean section; classes for single mothers,
lesbians, parents with a language barrier, parents with impaired hearing or
vision, and teen parents:  classes for mothers planning to give their babies
up for adoption; classes on vaginal delivery after a previous cesarean
section (VBAC); sibling preparation classes for other children in the family;
grandparent classes; adoptive parent classes; and breast-feeding classes.
Classes for parents after the delivery of the baby are also offered in many
communities.
     When choosing a childbirth class, you should remember that no childbirth
preparation method promises painless childbirth, nor will any method diminish
all of the discomforts of pregnancy.  The goal of childbirth education is to
give couples knowledge and confidence that will enable them to have a positive
experience of pregnancy, labor, and delivery.