Birthing classes and birth plans

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Birthing classes are classes to help parents to prepare for the birth of a baby and the first cares of a newborn, and a birth plan is a document created by a pregnant woman detailing her decisions and expectations regarding her labor and childbirth. [1] [2] [3] [4]

Contents

Birth plan

The birth plan may be simple or detailed and complex, depending on individual preferences, and may be revised over the course of pregnancy if desired. [4] One may be written at any point during pregnancy, though it is often recommended to do so during the third trimester and after the pregnant woman is provided with information about the physiology of delivery, as well as possible choices and risks. [3] [4] It is recommended that it be created with the support of a primary care provider. [3] Once created, it is provided to the obstetrical care providers, with the intent of facilitating communication and emotional support for the pregnant woman, as well as the humanization of childbirth. [3]

Birth plans were first introduced in the late 1970s and 1980s, in response to the effects of the medicalization of childbirth in which pregnant women had less and less control over the process and were instead expected to rely on decisions by medical practitioners. [1] [3] It has become increasingly popular in Western countries since then, and has been advocated for by the World Health Organization since 1996. [3] Because it promotes decision-making by women, it has been considered to advance female empowerment. [3]

In addition to preferences related to obstetrical care, a birth plan may include preferences for which individuals should be present at the birth for support, food and water intake, body position, care of the newborn regarding separation and skin-to-skin contact (Kangaroo care), breastfeeding, desired interventions if there are complications, pain relief, and cultural preferences. [3] [4]

A 2019 review of studies looking at the helpfulness of having a birth plan concluded that creation and use of a birth plan "positively influences the parturition process and maternal-fetal outcomes", though unrealistic expectations may cause a lack of satisfaction by some pregnant women. It stated that there was a need for greater awareness and support from medical professionals and use of flexible plans to increase maternal satisfaction. [3] Another review, done in 2022, concluded that birth plans "were associated with positive outcomes for childbearing women when developed in collaboration with care providers." It found that creation of a collaborative birth plan could improve medical outcomes, increase a sense of control and satisfaction, and promote realistic expectations. [1]

Birthing classes

Birthing classes, also termed antenatal classes, help the parents to prepare for the baby's birth and care of the newborn. Individual fears and concerns can be discussed with professionals and others in the class. Classes include learning about the process of labor and birth and various medications and other pain management options. The classes may include information about what area hospitals provide for women in labor, such as facilities for water births. Besides water births, pain management may include aromatherapy, massage, and other plans to help the mother in labor. Breathing exercises, such as those used in the Lamaze method may be introduced. Lamaze method teaches the use of a "birth ball" (yoga or exercise ball) and spontaneous pushing. The Lamaze method teaches that labor is best allowed to begin on its own rather than being induced when not medically necessary. [5] [6]

A support person, such as a partner, friend, or family member, may attend some or all of the classes. They can learn how to support the mother and how to help with relaxation techniques. The Bradley method of natural childbirth relies heavily on training partners or other support persons to be labor "coaches". The role that a doula has in supporting and assisting the mother is also discussed. A large recent study that looked at reports of continuous support for women during labor found:

Continuous support during labour may improve outcomes for women and infants, including increased spontaneous vaginal birth, shorter duration of labour, and decreased caesarean birth, instrumental vaginal birth, use of any analgesia, use of regional analgesia, low five-minute Apgar score and negative feelings about childbirth experiences. [7]

Some births require medical interventions. Women learn about the various drugs that may help her to cope with labor pains. A discussion of the use of pitocin or some other drug which may be used to induce labor as needed in some instances is discussed. [8] Information about different kinds of interventions such as Caesarean section, forceps delivery, or vacuum delivery are also explained and discussed with the expectant mother. [9]

Classes also teach early postpartum needs of the mother and her child. Some classes teach the importance of early skin-to-skin (SSC) care. It is supported by every major health delivery organization and the World Health Organization which states that "the process of childbirth is not finished until the baby has safely transferred from placental to mammary nutrition." WHO has designated hospitals that fulfill their Baby Friendly Hospital Initiative requirements as Baby Friendly. In the U.S., in 2019 more than 28% of births occurred in Baby Friendly hospitals in all fifty states with a total of 600. [10]

Some mothers, such as vulnerable, young mothers pregnant with their first child, may have special needs and need more assistance than what they receive in birthing classes. Nurse-Family Partnership (NFP) is a non-profit organization operating in the United States and the UK. Each mother served is partnered with a registered nurse early in her pregnancy and receives ongoing nurse home visits that continue through her child's second birthday. NFP intervention has been associated with improvements in maternal health, child health, and economic security. [11] [12]

Related Research Articles

<span class="mw-page-title-main">Childbirth</span> Conclusion of the human pregnancy with the expulsion of a fetus from mothers womb

Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million human births globally. In the developed countries, most deliveries occur in hospitals, while in the developing countries most are home births.

<span class="mw-page-title-main">Prenatal care</span> Medical check-ups during pregnancy

Prenatal care, also known as antenatal care, is a type of preventive healthcare. It is provided in the form of medical checkups, consisting of recommendations on managing a healthy lifestyle and the provision of medical information such as maternal physiological changes in pregnancy, biological changes, and prenatal nutrition including prenatal vitamins, which prevents potential health problems throughout the course of the pregnancy and promotes the mother and child's health alike. The availability of routine prenatal care, including prenatal screening and diagnosis, has played a part in reducing the frequency of maternal death, miscarriages, birth defects, low birth weight, neonatal infections and other preventable health problems.

A doula is a non-medical professional who provides guidance for the service of others and who supports another person through a significant health-related experience, such as childbirth, miscarriage, induced abortion or stillbirth, as well as non-reproductive experiences such as dying. A doula might also provide support to the client's partner, family, and friends.

A birthing center is a healthcare facility, staffed by nurse midwives, midwives and/or obstetricians, for mothers in labor, who may be assisted by doulas and coaches. The midwives monitor the labor, and well-being of the mother and the baby during birth. Doulas can assist the midwives and make the birth easier. Should additional medical assistance be required, the mother can be transferred to a hospital. This transfer is more likely if an epidural is needed, there is meconium staining, it is a prolonged labor, or the newborn needs intensive care. Some hospitals have birth centers as an alternative to the usual high tech maternity wards.

The Lamaze technique, also known as the psychoprophylactic method or simply Lamaze, began as a prepared childbirth technique. As an alternative to medical intervention during childbirth, it was popularized in the 1950s by French obstetrician Fernand Lamaze and based on his observations in the Soviet Union. The goal of Lamaze is to build a mother's confidence in her ability to give birth, through classes that help pregnant women understand how to cope with pain in ways that both facilitate labor and promote comfort, including relaxation techniques, movement, and massage.

Natural childbirth is childbirth without routine medical interventions, particularly anesthesia. Natural childbirth arose in opposition to the techno-medical model of childbirth that has recently gained popularity in industrialized societies. Natural childbirth attempts to minimize medical intervention, particularly the use of anesthetic medications and surgical interventions such as episiotomies, forceps and ventouse deliveries and caesarean sections. Natural childbirth may occur during a physician or midwife attended hospital birth, a midwife attended homebirth, or an unassisted birth. The term "natural childbirth" was coined by obstetrician Grantly Dick-Read upon publication of his book Natural Childbirth in the 1930s, which was followed by the 1942 Childbirth Without Fear.

<span class="mw-page-title-main">Pregnancy</span> Time of offspring development in mothers body

Pregnancy is the time during which one or more offspring develops (gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins.

<span class="mw-page-title-main">Unassisted childbirth</span>

Unassisted childbirth (UC) refers to the process of intentionally giving birth without the assistance of a medical birth attendant. It may also be known as freebirth, DIY (do-it-yourself) birth, unhindered birth, and unassisted home birth. Unassisted childbirth is by definition a planned process, and is thus distinct from unassisted birth due to reasons of emergency, lack of access to a skilled birth attendant, or other. It is also different from homebirth, although most UCs also happen within the home.

The Bradley method of natural childbirth is a method of natural childbirth developed in 1947 by Robert A. Bradley, M.D. (1917–1998) and popularized by his book Husband-Coached Childbirth, first published in 1965. The Bradley method emphasizes that birth is a natural process: mothers are encouraged to trust their body and focus on diet and exercise throughout pregnancy; and it teaches couples to manage labor through deep breathing and the support of a partner or labor coach.

<span class="mw-page-title-main">Men's role in childbirth</span>

The role of men in childbirth in the Western world has become more participatory than it was in the past. More Western women want their male partners to give active assistance during pregnancy and childbirth.

Tokophobia is a significant fear of childbirth. It is a common reason why some women request an elective cesarean section. Factors often include a fear of pain, death, unexpected problems, injury to the baby, sexual problems and a lack of self-belief of the capacity to birth a child. Treatment may occur via counselling.

A birth attendant, also known as skilled birth attendant, is a health professional who provides basic and emergency care to women and their newborns during pregnancy, childbirth and the postpartum period. A birth attendant, who may be a midwife, physician, obstetrician, or nurse, is trained to be present at ("attend") childbirth, whether the delivery takes place in a health care institution or at home, to recognize and respond appropriately to medical complications, and to implement interventions to help prevent them in the first place, including through prenatal care. Different birth attendants are able to provide different levels of care.

Childbirth positions are the physical postures that the pregnant mother may assume during the process of childbirth. They may also be referred to as delivery positions or labor positions.

The following outline is provided as an overview of and topical guide to obstetrics:

<span class="mw-page-title-main">Maternal health in Uganda</span>

Uganda, like many developing countries, has high maternal mortality ratio at 153 per 100,000 live births. According to the World Health Organization (WHO), a maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. In situations where attribution of the cause of death is inadequate, another definition, pregnancy-related death was coined by the US Centers for Disease Control (CDC), defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death.

Antenatal depression, also known as prenatal or perinatal depression, is a form of clinical depression that can affect a woman during pregnancy, and can be a precursor to postpartum depression if not properly treated. It is estimated that 7% to 20% of pregnant women are affected by this condition. Any form of prenatal stress felt by the mother can have negative effects on various aspects of fetal development, which can cause harm to the mother and child. Even after birth, a child born from a depressed or stressed mother feels the affects. The child is less active and can also experience emotional distress. Antenatal depression can be caused by the stress and worry that pregnancy can bring, but at a more severe level. Other triggers include unplanned pregnancy, difficulty becoming pregnant, history of abuse, and economic or family situations.

This article provides a background on Nepal as a whole, with a focus on the nation's childbearing and birthing practices. While modern Western medicine has disseminated across the country to varying degrees, different regions in Nepal continue to practice obstetric and newborn care according to traditional beliefs, attitudes, and customs.

In its early history, Mexico was occupied by a large number of indigenous tribes such as the Mayans and Aztecs. In the 16th century, Spain colonized New Spain and took over the land from the indigenous peoples. Though it is now an independent nation, Mexico retains much of the cultural influence of Spain, including its official religion of Catholicism, the Spanish language, and the importance of machismo - the belief that men are superior to women. Mexico also retains much of the traditional beliefs of the indigenous peoples who first occupied the country. Besides Spanish, there are over one hundred different languages spoken in the country today. As a result, the current medical system involves a mix of traditional and Western medicinal techniques.

The maternal mortality rate is 224 deaths per 100,000 births, which is the 23rd highest in the world. The mean age of mothers at birth is 19.3 years old, and the fertility rate is 5.72 children born per woman, which is the 7th highest in the world. The contraceptive rate is only 40.8%, and the birth rate is the 4th highest in the world at 42.13 births/1,000 population. Infectious disease is a key contributor to the poor health of the nation, and the risk is very high for diseases such as protozoal and bacterial diarrhea, hepatitis A, typhoid fever, malaria, dengue fever, schistosomiasis, and rabies. The adult prevalence rate of HIV/AIDS is 12.37%, which is the 7th highest in the world.

<span class="mw-page-title-main">Pain management during childbirth</span>

Pain management during childbirth is the partial treatment and a way of reducing any pain that a woman may experience during labor and delivery. The amount of pain a woman feels during labor depends partly on the size and position of her baby, the size of her pelvis, her emotions, the strength of the contractions, and her outlook. Tension increases pain during labor. Virtually all women worry about how they will cope with the pain of labor and delivery. Childbirth is different for each woman and predicting the amount of pain experienced during birth and delivery can not be certain.

References

  1. 1 2 3 Bell, Catherine H; Muggleton, Sally; Davis, Deborah L (1 August 2022). "Birth plans: A systematic, integrative review into their purpose, process, and impact". Midwifery. 111: 103388. doi:10.1016/j.midw.2022.103388. ISSN   0266-6138. PMID   35640358. S2CID   249071121 . Retrieved 19 November 2022.
  2. ↑ Mirghafourvand, Mojgan; Mohammad Alizadeh Charandabi, Sakineh; Ghanbari-Homayi, Solmaz; Jahangiry, Leila; Nahaee, Jila; Hadian, Tahereh (August 2019). "Effect of birth plans on childbirth experience: A systematic review". International Journal of Nursing Practice. 25 (4): e12722. doi:10.1111/ijn.12722. ISSN   1322-7114. PMID   30675962. S2CID   59224726.
  3. 1 2 3 4 5 6 7 8 9 Medeiros, Renata Marien Knupp; Figueiredo, Graziele; Correa, Áurea Christina de Paula; Barbieri, Márcia (6 June 2019). "Repercussions of using the birth plan in the parturition process". Revista Gaúcha de Enfermagem. 40: e20180233. doi: 10.1590/1983-1447.2019.20180233 . ISSN   0102-6933. PMID   31188973.
  4. 1 2 3 4 Australia, Healthdirect (6 May 2022). "Making a birth plan". Healthdirect Australia. Retrieved 19 November 2022.
  5. ↑ Isaacs, Christine. "Thinking About Childbirth Without Pain Medication? Here's How to Prepare". ACOG. Retrieved November 20, 2022.
  6. ↑ "Antenatal classes". NHS. December 2020. Retrieved November 30, 2022.
  7. ↑ Bohren, M. A.; Hofmeyr, G. J.; Sakala, C.; Fukuzawa, R. K.; Cuthbert, A. (2017). "Continuous support for women during childbirth". The Cochrane Database of Systematic Reviews. 2017 (7): CD003766. doi:10.1002/14651858.CD003766.pub6. PMC   6483123 . PMID   28681500.
  8. ↑ "Inducing labor: When to wait, when to induce". Mayo Clinic. Retrieved December 1, 2022.
  9. ↑ "Antenatal classes". NHS. December 2020. Retrieved November 30, 2022.
  10. ↑ "The Baby-Friendly Hospital Initiative". Baby Friendly USA. Retrieved December 1, 2022.
  11. ↑ Miller, Claire Cain (25 July 2017). "How Home Visits by Nurses Help Mothers and Children, Especially Boys". The New York Times. Retrieved December 6, 2022.
  12. ↑ "Nurse-Family Partnership". Social Programs that Work. Retrieved December 4, 2022.
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