Birth classes, for the longest time, really covered the BASICS of labor. They didn’t dive into problems you might have, or how to manage them. Studies are showing that this type of birth class isn’t doing families any favors. Today I’m going to dive into what a recent study shows, and how you can get a class that will truly prepare you!
Before we get started — how do I know so much about birth education? Hi, I’m Hilary, and many of you guys know me as The Pregnancy Nurse®. I’ve been a nurse since 1997 and I have 20 years of labor and delivery experience, including both teaching classes at my hospital and seeing how those classes really prepared my patients vs those who didn’t take the classes.
I was really excited to see that this study showed what I had seen with my own eyes for years.
And, in case you’re looking for a birth class, I recommend this one — we’ll talk more about why THAT one in a bit.
What Do Most Birth Classes Provide?
This study reviewed digital platforms for before-birth education. They showed that:
- 12/55 included general prenatal topics (like nutrition)
- 6/55 focused on labor-related events like VBAC
- and none of them included information on inductions, cesareans or episiotomies
None of them. My jaw dropped. I mean, that’s what you’re there for, right?
I liked this quote from it: “Overall antepartum CBE appears to be inconsistent in providing information about potential complications in labor and birth that might ultimately improve intrapartum informed consent.” They also went on to say that most classes only covered PLANNED events rather than the UNPLANNED event.
Study Source: https://doi.org/10.1111/jmwh.13683 (from the Journal of Midwifery & Women’s Health 12 August, 2024 — Antepartum Preparation and Consent for Intrapartum Events: An Ethical Gap
Ok, let’s define a few of these terms are related to labor & birth:
Informed Consent: This is when your provider goes over the risks, benefits and alternatives to a procedure. It is encouraged to use shared decision making in this process where the patient is an active collaborator in this discussion and the provider is there to talk about what information is available like studies and evidence.
Planned Events in Labor: This tends to be more about the stages of labor, some natural breathing techniques because pain is likely to be involved in your birth.
Unplanned Events: These are things that are not “usual” but also aren’t uncommon. Things like inductions, c-sections, needing an episiotomy, use of a vacuum or forceps. We’re not talking about really weird events that even the providers rarely see — we’re talking about things that often happen that people should have some preparation for.
A good birth class should:
- Help you become an active participant in informed consent (because it is FAR too easy to be pushed into what the doctor recommends if you’re not able/willing to ask more questions)
- Cover what’s expected in labor — those planned events (but this should not be the majority of the class)
- Cover unplanned events. They should have whole sections about ceseareans, inductions, and it should go into common interventions that will happen in the hospital.
Why Unplanned Events?
I think a lot of people want to stick their head in the sand and pretend like their birth will go just like the stages of labor videos — nothing will deviate. But, giving birth in the here and now means that many of you are high risk, or may develop issues as you head into the end of your pregnancy. Things like:
- IVF
- Diabetes
- High Blood Pressure
- Preeclampsia
used to not be that common — but today they’re almost routine, yet — most birth classes haven’t evolved to cover them.
This is only talking about unplanned events in pregnancy. What about unplanned postpartum events, like constipation, pain in your bottom, postpartum depression, or issues breastfeeding.
Most birth classes only glance over postpartum life (mine 100% did) be SURE to get a class that covers postpartum as well — how to notice problem signs, and tips on how to thrive. This one does.
What Are Patients Choosing?
The study showed that patients have conflicting feelings about childbirth education.
Some felt that more information allowed them to have better autonomy and decision making.
Some felt that the classes gave them information overload and they couldn’t use the information during labor or birth.
Some patients also chose to just avoid information entirely as their method of coping with the unknown.
It’s your choice to figure out which method would be best for you.
Frankly, I do think that a lot of social media tends to give people information overload (along with a lot of mis-information) that isn’t helpful as they prepare for birth.
I recommend a birth class that is just a few hours long. It briefly covers planned events in labor, and then has more information on those other unplanned events.
Why Not Avoid Information?
Because labor can be really scary. It is not an uncommon event for 5+ nurses to run into your room, ask you to turn, turn up your IV and monitor you and your baby very carefully.
If that were to happen in other areas of the hospital, you might be dying — but in labor we’re always helping and watching out for each other. When you KNOW this is going to happen you’re not as freaked-out when it does happen.
I also strongly feel that our propensity to just put our head in the sand have created some of the maternal mortality in the US. People don’t know what to watch for on their own, how to communicate with their healthcare team or how to make choices for themselves.
Something I See a Lot
The thing I see the very most is people having some third trimester testing that’s off. Their provider recommends a possible induction of labor, even though their cervix is not favorable.
They aren’t aware of how long and possibly painful that induction could be.
They’re not aware that movement should be an integral part of that induction (and instead spend much of it in bed unhappy about the process).
They’re begging for a cesarean because they’re just tired of the process.
Education could’ve entirely helped this process:
- Understanding the spectrum of “recommending an induction” and how important is to do it RIGHT then (or if they could wait and monitor a bit longer)
- Understanding how long an induction can be, and things they can possibly do to help it move along
- Understanding the risks of a cesarean to have a really in depth conversation with their provider before choosing that.
- Understanding what to expect during a c-section and recovery from it to avoid trauma there
And frankly, maybe what they could have done a few weeks in advance to get their cervix a bit more prepared for an induction — things like primrose oil or dates (I recommend talking with your provider before trying either of those).
What Are Providers Doing?
I really think that providers are doing a LOT better at providing informed consent for patients, but patients often also want to stick their head in the sand and just let the provider make the choice they recommend, rather than having this conversation.
I see often that people just plan on prenatal appointments being enough to prepare them for birth, but there just isn’t time to check on YOU, and provide all the information to prepare you for birth.
You should plan on extra information beyond that.
And yes, you might be able to spend hours and hours looking things up on the internet, but most people find that taking a class simplifies things (and allows you to prepare with a partner).
A Birth Class that Prepares You
That study showed that most classes don’t prepare you for unplanned events. In this age of digital learning I’ve found that a lot of classes are really poorly done and people aren’t really equipped to prepare you for birth.
Which is why I recommend The Online Prenatal Class for Couples. It is designed to:
- NOT overwhelm you — just 20 minute “birth bites” will allow you to digest information on your own
- Cover the basics & those other interventions — it covers about 98% of births
- Be done with a partner so you’re not left to explain things to them along the way.
Plus, it’s created by an experienced labor & delivery nurse who really knows what you need to know.
There’s even a bonus video on talking with your birth team to get the information you need and get your voice heard.
Let me remind you — with that study the VAST majority of online education is NOT preparing you the way you need to be. Honestly, I also think a lot of hospital classes aren’t that helpful either — so finding a class that covers both planned, and unplanned events is key. The good news is that this one is just ready & waiting for you.
If you have questions about it — don’t hesitate to ask them in the comments!
Don’t miss my great big post on everything you need to know about birth classes << for more information this important subject!
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