Don’t Take a Childbirth Class Unless You Know Who’s Really Paying the Instructor

In the last post here at Mothering Outside the Lines we were talking about how to have an empowered labor and delivery.

You might have noticed that I did not suggest taking a childbirth class to prepare.

In her book, Misconceptions, Naomi Wolf writes about how many childbirth instructors are actually employed by hospitals. If they aren’t being paid directly (as many of them are), they are getting their clients through hospital referrals.

Instead of giving true information and really empowering first-time moms, these instructors are often regurgitating hospital policy, showing videos of women being docile and obedient in labor instead of teaching real pain management techniques.

Hint: breathing and panting and staring soulfully into your partner’s eyes all fly out the window when contractions slam your body. Primal noises, animal sounds, shrieks, cussing (”You f——g a—–e WHY DID YOU DO THIS TO ME?”), and deep moans like the ones you made while you were enjoying yourself getting the baby in there in the first place all tend to work much better.

But, as Wolf points out in her book, these fierce and empowering screams to get you through contractions are not “socially acceptable” or “publicly acceptable.”

When you’re in hospital you’re in a quasi public place. The nurses on staff, the other laboring moms and their partners and families, the doctors, the janitors, and everyone else at the hospital (like expectant couples touring the ward) will hear you if you’re managing your pain loudly.

Loud pain management = good for mom to release tension and enjoy labor.

Loud pain management = social embarrassment for all the non-laboring people who would be much happier if you would just. shut. up.

More to the point, a hospital makes much less money if you manage your own pain.

I will write that sentence again in case you were sipping your coffee and skimming: A hospital makes much less money if you manage your own pain.

Almost everyone in the hospital has a vested interest in shooting you and your emerging baby up with pain medication in the form of narcotics or an epidural. What’s wrong with that? Once you’re doped up, you’re tied down, tethered by an IV or an epidural. Which means you can’t walk around anymore, or squat, or get on all fours, or hug your helpers, or hang from their arms. But movement during labor not only helps you open up and birth your baby, it helps you manage what can otherwise feel unbearable.

Once you’re quiet and docile, chatting with your partner instead of working with your body, your baby, and your hormones, the deck is stacked against you. You’re so wired to the bed that you might as well be tethered there, as women of my mother’s generation were. Gravity is no longer on your side. A baby needs to slip under your pelvic bone but the space is now constricted because you’re lying on your back or are semi-recumbent in bed.

Some well-meaning friends gifted us a childbirth class when we were pregnant for the first time eleven years ago.

I remember the instructor’s voice often caught when she talked about her oldest child’s birth.

Since her labor wasn’t “progressing fast enough,” the hospital midwives made her stimulate her own nipples.

Rub-rub-rub. Stop. Rub-rub-rub. Stop.

But the instructor never honestly explained how she felt about that birth. Instead, she presented all the “options” that the hospital presents to laboring women. Hanging off the doctor for dear life during transition is not one of those options.

Now that I’m reading Wolf’s book as part of my larger research on how corporations and private interests are skewing the way we treat babies in utero and through the first year of life, I’m beginning to understand better why our childbirth instructor wasn’t being honest. In the hospitals in Atlanta, which is where we lived at the time, there is very little room for women to have the births they want. Instead of psychological support, I was treated with impatience and scorn during labor (Nurse who checked my dilation after more than 12 hours of excruciating active labor: “Nothing. Not even a dimple.”)

Suzanne Arms, writing in her now classic 1975 book Immaculate Deception (a book which launched a home birth movement in the United States), talks about how childbirth instructors are often part of the problem, part of a complicity of silence that keeps women transitioning into motherhood literally flat on their backs.

Unfortunately, I fear that Arms’ insight is still true today.

There are exceptions, of course. But most childbirth instructors have to be aware that they are navigating a political and financial minefield and they have to be very careful about what they say and how they say it. (This is true for midwives as well. Especially hospital midwives. Sadly, many of the midwives quoted in Naomi Wolf’s book would only talk to her off the record because they didn’t want their names to be used for fear of losing their jobs or angering their colleagues by telling the truth of how laboring women are being treated in hospitals today.)

In the community in southern Oregon where I live people pride themselves on being progressive and forward thinking. When a public panel was being put together to inform pregnant women about birthing options, one of the panel organizers wanted to invite me to speak about my unassisted childbirth. The panel included women telling the stories of Cesarean hospital births, medicated hospital births, natural hospital births, and home births with certified midwives present. I was one of three women who had unassisted births in our city in less than a year. But the committee balked. “We would not want to be seen as presenting that as an option,” a committee member said to my friend when her proposal to invite me was rejected.

One of the reasons I recommended some of the more radical books in my post on how to have an empowered birth is because if you read those books a simple home birth with trained midwives starts to seem like a straight and narrow option. It’s certainly much less radical than an unassisted home birth VBAC after three hospital C-sections (which is one of the amazing stories told in Simply Give Birth.)

You don’t need an childbirth “expert” or a panel to tell you how to have your first baby. You may get more honest answers and be better off in the long run if you do your own research.

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10 thoughts on “Don’t Take a Childbirth Class Unless You Know Who’s Really Paying the Instructor”

  1. This is a commentary on childbirth educators employed by hospitals, but makes no mention of independent educators (like Bradley, Hypnobirthing, Birthing From Within) instructors who are almost never employed by anyone except themselves, and go out of their way to inform parents of all the mistreatment seen in hospitals today. Does the author even know that these classes exist? Most doulas in my area (including myself) won’t even accept a client who hasn’t taken an INDEPENDENT childbirth education class, and there’s a good reason why.

    My, personally, I did my student teaching for my CBE in a hospital class, and was both thoroughly horrified by the things that the Lamaze credited instructor was telling the students, but also thoroughly relieved that I was there to give those parents the TRUTH. I got two doula referrals out of that session when the parents realized that the type of birth they wanted was NOT going to happen in the hospital they chose, but didn’t really have time to scout out a new provider.

    Hospital educators who try to teach women panting on a Saturday should be condemned here, but let’s not through the good childbirth educators out with the bathwater. Independent childbirth educators are a completely different breed and we should be encouraging EVERY mother to take a class with them, especially if they plan on birthing in a hospital.
    .-= TheFeministBreeder´s last blog ..We

  2. I concur with The Feminist Breeder. As an independent childbirth educator, I am beholden to no one other than the students who pay me! I am free to give evidence-based, rather than policy based, information.

    I do get where this article is coming from. I took a typical hospital class with my first and wound up with an induction, epidural, AROM and eventual c-section because my time was up. I went on to take independent classes with my second pregnancy and had a totally natural VBAC. So yes, I get that hospital educators very often focus more on policy than actual techniques, or God forbid – AUTONOMY!

    But to lump me, an independent educator, in with certain hospital educators who knowingly deceive women as they prepare for their births… well, I find that offensive.
    .-= Mandi´s last blog ..Wednesday Night Childbirth Classes Beginning January 12- 2011 in Upland- CA =-.

  3. I have to agree with The Feminist Breeder and Mandi. I am a CBE now switching to Brio Birth and love teaching informed choices in my classes. I have a friend who taught at a local hospital who really felt torn at times in her instructing b/c she couldn’t fully give information b/c she was told not to…it would make the doctors upset.

    I am tired of stepping on toes to make those doctors feel better about themselves. I am for empowering my students with knowledge and the strength to make hard choices. I give them research so they can take it to their health provider to get a real answer. I never deceive nor hide the truth to my clients. I do not make the choice for them.

    While I do understand that we labor support professionals (Doulas, CBE, LD’s, etc.) have a job of informing our clients and not imposing our preconceptions, I don’t think we should hold our tongues when it comes to information. If we do, we are failing our clients.

    My students tell me often they feel they couldn’t have gone through their births w/o the knowledge I imparted to them. I feel great about that and am happy to say it makes them feel better about the birth no matter what the outcome may be. To say I’m part of the problem is just an insult to my intelligence.

    While a new mother can do her own research, there is a place for someone helping you along the way to gain that knowledge. Not too long ago, you must remember we as women would have seen our mothers, aunts, sisters, cousins, and friends birthing before we gave birth. We now live in society where women rarely witness a true natural birth. Independent childbirth classes do have their place; I just wish you would have brought that point home further.

  4. A Bradley childbirth class was what gave me the confidence to switch to a midwife and home birth at the last minute, as I decided that the reason I couldn’t find peace with the idea of a hospital birth was that I knew from my conversations with my OB that I would be subjected to a string of unwanted interventions if I had showed up at the hospital. I wish more parents knew that childbirth classes are not all alike. I can hardly believe that at one point I wanted to take a hospital class because it was quick and convenient. You get what you pay for!


    Founder of

  5. I am a certified Lamaze educator who happens to teach for a local hospital. Our hospital teaches research based practices and encourages women to move around, make noise and have several support people present. I think not recommending that women take a prenatal class is doing them a disservice. There are a lot of really great prenatal teachers out there who work for hospitals.

    I am in Canada however where our hospitals are less political and money driven. They are certainly not devoid, however it is not a “business” like the American hospitals are. Perhaps this is why prenatal education and birthing practices are more progressive.

    It has been my experience in talking to parents after my classes that they do in fact feel more prepared and that their partners feel more prepared going into the birthing experience. Women know and practice making noises, position changes as well as what to expect in the labour process. Their partners also learn what to expect and that noise is normal that if a woman yells, moo’s like a cow or becomes very internal this is all normal. Watching videos in class that are not available to the general public or that are too costly are also shown. Anything other than “A Baby Story” has to be a step up. My clients are encouraged to become active consumers in their own care and to ask questions every step of the way. They are told that their doctors and nurses are not gods, however they do have lots and lots of experience and education to back them up.

    I think that Childbirth education is changing and that without childbirth educators telling women how birth can be and should be we are doing them a disservice. We are sometimes the only ones to tell them that they can give birth without being medicated. The can feel empowered in their choices and sometimes that starts with good education.

    Jennifer Young


  6. Not all childbirth education courses are created equal. I agree with the above posters that independent childbirth education is not only helpful, but (in my opinion) an essential ingredient for a great birth experience. Are they necessary? No. But gathering information so you can make informed choices (and then doing so during your prenatal care and birth) are necessary. Some parents choose to read many books and gather their info via the internet. Others choose to research a quality, independent childbirth course. There are many different ways to prepare for the birth you want and I strongly believe that childbirth classes are a great option. But do your homework and find out what you will be learning and who is paying them before signing up!

  7. It’s good to see some independent providers bringing their perspectives here (though, isn’t the post titled ‘…unless you know who’s really paying the instructor’?). Clearly parents need to look for instructors like these, and steer clear of hospital indoctrination sessions. The theme I see over these posts–at least as I see it from my perspective–is that the movement away from over-medicalizing birth should be a cooperation of all those involved in birth: childbirth-class instructors, direct-entry midwives, CNMs, OBs, L&D nurses, parents and the writers and film-makers getting the message out there.

    It’s not a woo-woo position; it’s a scientific perspective. Medical interventions are lifesaving in rare emergencies; but evolution prevents life-threatening problems in birth arising any significant percentage of the time. Failures and fatalities around reproduction are very strongly selected against, because they cannot be passed on to a new generation.

  8. I live in an area where this issue is divided. We have 2 hospital systems here, one where their childbirth ed classes are made up of a curriculum by their physicians & one where the educator is also a doula and her classes are great. I am going for my teaching certification & tried to get in to audit a class at the hospital closest to me which was the physician’s curriculum & they wouldn’t even allow it. On the other hand I did get in & audited the other classes and they were great.

  9. I have been taking a private hypnobirthing class in anticipation of the birth of my first child in May. One of the first things we talked about is laboring at home. Incidentally, the instructor and I are using the same (hospital birthing) midwifery practice. I trust my midwives and feel really comfortable with them as did my hypnobirthing teacher. She did say however, that once you are at the hospital, you are on the hospital’s time line and regardless of how great your midwife is, she is also on the hospital’s timeline. A big part of the class is geared towards empowering me and my husband to trust my body and labor at home for as long as possible. My instructor labored at home and went to the hospital 9 cm dilated and had her baby an hour later with little intervention.

    This is great advice IMO but also indicative of what you are speaking about. The hospital does not want to hear you, see you, deal with you laboring. Once you go to the hospital, you are monitored and pumped with fluids and you must deliver within a 24 hour period or often times sooner. The hospital staff will say things to scare you, like how slow you are dilating, how tired you look, how impatient everyone in the waiting room is getting. It is sad that the best advice I have gotten so far regarding labor and delivery is to stay as far away from the medical community for as long as possible during labor.

  10. I just wanted to say that I LOVED the childbirth class we took, led by a doula, intended for parents having a home birth. If everyone had access to such excellent childbirth education, I know fewer women would resort to medication. Knowledge and preparation are power.
    .-= Em´s last blog ..Merry Christmas! =-.

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