Maternal Education and Nursing Responsibilities

What is Childbirth Education

    Childbirth
education focuses on the learning needs of expectant families and covers a
broad range of topics from the physical care needs of expectant women to the
psychosocio cultural needs of the new family. 

    The goal of childbirth education
is to assist families in acquiring the knowledge and skills necessary to
achieve a healthy transition through the childbearing process and initial
phases. of parenthood. 

    Classes range from courses designed for those
considering pregnancy through courses dealing with infant care needs and early
parenting issues.

Nursing Role In Childbirth Education

    Nurses
are the professional practitioners who assume the primary responsibility for
teaching childbirth education classes within the United States. 

    Nurses are in a
unique position to serve as childbirth educators because of their broad base of
knowledge including both the behavioral and biological sciences. In addition,
nursing’s focus on caring and emphasis on client education enable nurses to
guide families toward their childbirth goals with sensitivity using appropriate
educational methods. 

    Nurses are the health professionals within the hospital
environment who provide the majority of hands-on care and labor support. 

    Thus,
nurses are in a strategic position to act as patient advocates and to provide
anticipatory guidance regarding the decision making that is often required
during a birth within an increasingly complex health care system.

Formal Child Birth Education

    Formal
childbirth education in the United States began with the classes in hygiene,
nutrition, and baby care provided by the American Red Cross. During the early
part of the 20th century, classes on childbirth and family care became
increasingly available to American women. 

    However, the classes provided little
information regarding coping with the stresses related to labor. With the shift
from the female controlled, social model of child-birth to the medical illness
model of child-birth that occurred during the first half of the 20th century,
the scientific community paid increasing attention to the control of pain
during labor. 

    Thus, classes initially focused on management of pain related to
childbirth (Ondeck, 2000). Contemporary childbirth education dates back to the
work of Dick-Read, Lamaze, and Bradley. 

    The notion of pain during labor as
secondary to fear and the use of psychological conditioning methods to reduce
both the fear and the pain became the basis for “natural childbirth.”
While philosophical differences still exist among childbirth education methods,
common aspects of all programs include education on: 

(a) the physical process
of labor

(b) physical and psychological conditioning methods

 (c)
supportive assistance during the birthing process.

CINAHL Literature Overview On Childbirth Education

    A
review of the Cumulative Index to Nursing and Allied Health Literature (CINAHL)
for the years 1997-2003 reveals 173 published research-based articles listed
under the keywords “childbirth education.” 

    wide variety of topics
are covered including: 

(a) postpartum skills such as parenting and
breastfeeding

(b) classes for special populations such as grandparents, siblings,
fathers, teens, disabled persons, and preparenthood couples

(c) effects of
mother-friendly and baby-friendly hospital protocols

(d) self-care measures
during pregnancy and labor such as nutrition, fitness, pain control, breathing,
and relaxation techniques

(e) effects of medical interventions such as
epidural anesthesia, analgesics, and cesarean deliveries

(f) caregiver effects
focusing on the outcomes achieved by midwives and doulas

(g) childbirth
educator competencies and reaching methods.

Expectant Father And Child Birth Education

    Expectant
fathers are currently the focus of many research efforts. Greenhalgh, Slade.
and Spiby (2000) reported that fathers at rending childbirth education classes
who wished to avoid information perceived as threatening had significantly less
fulfilling childbirth experiences than similar fathers who did not attend
classes. 

    These finding questions whether traditional mother-focused childbirth
education classes meet the varying needs of fathers, some of whom are eager to
participate in the childbirth experience and others who are reluctant to do so. 

    Diemer’s (1997) quasi-experimental study comparing traditional prenatal classes
with classes using father-focused discussion groups found a decrease in
psychological symptoms and greater improvement in spousal relationships for men
attending father-focused groups. 

    The need for attention to the special
interests of fathers was also supported by the work of McElligott (2001) and
Smith (1999) who reported men’s need for information about their unique
contribution to the childbearing experience.

Prenatal Education Related to Breast Feeding

    Prenatal
education related to breast-feeding continues to be a major focus of research.
Cox and Turnbull (1998) reported that at tending a breast-feeding workshop
significantly increased both women’s confidence level and the length of time
the women breast fed their infants. 

    Britton’s (1998) qualitative study of the
sources used by women for breast-feeding information identified discord between
women’s expectations of breast-feeding and the reality of the experience. 

    This
study underscored the continuing need for prenatal breast-feeding education
courses and development of peer-support and self-help groups.

    A
third area receiving continuing attention concerns childbirth education methods
and content. The need for use of adult learning principles and identification
of specific learner needs is continually reinforced. 

    In addition, extension of
the traditional childbirth education program to include gender-specific
information on early parenting skills is supported (Callaghan, Jones, & Leonard,
2001; Schmid, Myors, Wills, & Cook, 2002).

    Lamaze
International (2002) presented a position paper for the 21st century which
identifies the need to reshape the birth environment to be supportive of
women’s confidence, control, and comfort as we

    ll as maintaining rewarding
family interactions through encouragement and support. With the advent of the
mother-friendly and baby-friendly initiatives, additional research is needed to
identify educational needs of both consumers and practitioners that will support
cost-effective, collaborative policies and high levels of consumer
satisfaction. 

    In addition, continued examination of the traditional course
content in light of the needs of fathers and special populations is required.
Use of the internet as a media for childbirth education has not been reported
in the literature. 

    Online courses and support groups may provide a fruitful
avenue for childbirth educators wishing to provide high-quality, yet
convenient, classes for today’s busy families.