When clients do not go to Prenatal Classes/Childbirth education

KittyPaws · 09-06-2008, 02:57 PM

I am starting my prenatal visits with some clients in a few weeks who refuse to attend childbirth education/prenatal classes. Does anyone have experience with clients like this. How much extra stuff should I be going over with them. I am trying to get into one of our local childbirth education classes as an observer so I can see what is discussed but any kind of advice you guys may have would be greatly appreciated.

amymaew · 09-06-2008, 03:00 PM

Why do they refuse to go? I don't go over anything extra with them - I figure if my clients don't want to go to CBE classes I'm not going to teach them the same stuff for free. I'll go over the basics, but that's it.

Wendy79 · 09-06-2008, 04:22 PM

I agree that it's important to know why they don't want to do childbirth classes. I have known quite a few people who aren't bothering--they feel like they've collected a lot of information on their own, aren't overly concerned about learning breathing techniques and positions ahead of time (after all, how many women tell us that once they're in labor, it all goes out of their heads?), and would rather spend the time and money elsewhere. For the right people, I respect that, and that's why I don't have any clauses about clients needing to take a class--I know many doulas do.

But if they're not taking classes because they expect you to take the place of prepared childbirth, you may need to go over with them the limitations of what you can provide and how preparing ahead of time (whether through a class or independently) will help with labor and delivery--both their experience of it, and the likelihood that things will go the way they hope.

There are lots of ways to prepare for childbirth other than classes, just like there are other ways of doing "prenatal care" besides VEs and ultrasounds and vitamins. Ignoring the need for preparation and expecting your doula to do it all once you're in the L&D suite isn't one of them! So try to find out more.

FLLucinda · 09-07-2008, 02:18 PM

I agree with all written above and I also send them to these sites because there is not enough time to teach them all they need to know during prenatals and if I were teaching classes it would be an extra fee.....These two websites give them a ton of information!

http://www.birthingnaturally.net/ Birthing Naturally

http://pregnancy.about.com/od/childb...a/cbeclass.htm Robin Weiss has one of the most phenominal websites I've ever seen for pregnancy and birth!!

doula Michele · 09-07-2008, 05:52 PM

I have lots of clients who do not bother with public health classes. We hit the high spots in our prenatals, but other than that....baby goes in, baby comes out. If they do not educate themselves, thats their problem and not mine.

nicole.schwartz · 09-08-2008, 11:49 PM

As part of my contract I explain the importance of having a foundation of knowledge about true choices in childbirth, the physiology of birthing experience, etc and require all first time families to take a childbirth prep class.

I don't require that they take a specific one, but discourage only taking a hospital-based course. I provide a list of local instructors and the Philadelphia Guide to a Healthy Birth.

I haven't had any clients outright refuse. Although I have a family right now that hired me, agreed to take a "full series" and then took a one day class at a local maternity center. They are definitely lacking the necessary information and it is causing anxiety and "issues" with mom (who called me last night at a less than ideal hour and described having "contractions" that were lasting 30-40 MINUTES each !!!!!! She isn't due until next month...anyway, I digress)

I truly believe that preparation is just as important as your "plan" to birth the baby. This is a core value and I would turn down clients that are not interested in being truly prepared....It is too late to (intellectually) learn things when you're in labor. You'll learn a lot..but that is too late to be learning natural childbirth preparation.

amymaew · 09-09-2008, 06:17 AM

Quote:

Originally Posted by nicole.schwartz

Although I have a family right now that hired me, agreed to take a "full series" and then took a one day class at a local maternity center.

Make that two families

nicole.schwartz · 09-09-2008, 07:14 AM

Quote:

Originally Posted by amymaew

Make that two families

WHHHHHHAAAAATTTT?
They're only taking ONE class in your series?

I THINK NOT!

doula Michele · 09-09-2008, 10:18 AM

Some of my best births have been with clients who have not taken any classes. I encourage them to read and research some stuff... but if they don't want to, then thats their call.

DoulaMegz · 09-10-2008, 10:43 AM

So this largely addresses clients who choose not to take a class, what about clients who are UNABLE to? I have a mom due October 4th who admits being scared out of her mind about the birth, but wants to go without an epidural. She was unable to take a class for a variety of reasons. What should I cover with her? (we will likely squeeze in 3 to 5 prenatals, as she is with my non-profit agency that serves an at risk community) I want to put her at ease so she can feel safe and trust her body to go through this process. It's her first. What are the top 5 topics you would review?

FLLucinda · 09-10-2008, 04:51 PM

Quote:

Originally Posted by DoulaMegz

So this largely addresses clients who choose not to take a class, what about clients who are UNABLE to? I have a mom due October 4th who admits being scared out of her mind about the birth, but wants to go without an epidural. She was unable to take a class for a variety of reasons. What should I cover with her? (we will likely squeeze in 3 to 5 prenatals, as she is with my non-profit agency that serves an at risk community) I want to put her at ease so she can feel safe and trust her body to go through this process. It's her first. What are the top 5 topics you would review?

Sorry, Megz I gave you 6!!

1) Late pregnancy, nutrition, exercise
2) Optimal fetal positioning & importance of - positions to accomplish this during late pregnancy and labor
3) Comfort measures during late pregnancy and birth, pre-labor, when to go to hospital, relaxation methods
4) Stages of labor and what is happening at each stage
5 ) Common procedures for labor/delivery - hospital procedure - medications, interventions, and complications
6) Postparum care of mom, baby, and breastfeeding...if bottle feeding- help with that

b'earth angel · 09-10-2008, 07:11 PM

I do ask that my clients attend childbith ed and "have the desire to educate themselves about birth". This is my preference, but is not written in stone by any means. If I have a mom that's given birth before or attended a CBE series previously, I'm okay w/that. However, if I have someone who isn't at all interested in educating themselves by a repeated refusal to read or view matterials, lack of interest, etc, that's reason enough for me to void the contract. I will not take that responsibility on for any client.

Around here, all we have are hospital based CBE series. The one I audited was good too. She focused more on mother-friendly type care and went into great detail w/epi and c/s proceedures. Even brought out the epi kit and went through every piece in the tray.

But not all CBEs are created equal I know.

SuzanneTx · 11-02-2008, 05:26 AM

discourage only taking a hospital-based course.

I take great offense to this statement. I teach a hospital based CBE and it is great! Even to the point of explaining to the parents that it is THEIR delivery and they should have it their way. I also go on to explain their rights to them.

Around here, all we have are hospital based CBE series. The one I audited was good too.
Thanks for at least giving us some credit.

Suzanne

FLLucinda · 11-02-2008, 09:47 AM

Quote:

Originally Posted by SuzanneTx

discourage only taking a hospital-based course.

I take great offense to this statement. I teach a hospital based CBE and it is great! Even to the point of explaining to the parents that it is THEIR delivery and they should have it their way. I also go on to explain their rights to them.

Around here, all we have are hospital based CBE series. The one I audited was good too.
Thanks for at least giving us some credit.

Suzanne

Suzanne, I agree with you on this. In my former area I audited one and took my ICEA training from the CBE Coordinator (who is also CD DONA) and it was stressed that as long as everything is ok with mom and baby there is no reason they should not be able to stick to their birth wishes. I found this to be true as a doula in the hospitals they taught in. Also I attended births in military hospitals that CBE was taught by other instructors and again...from talking with my doula clients...what was being taught was facts but stressing rights of the mom/dad. Trust your body for birth was the message. They in no way taught anything to "brainwash" or "coerce" students...

I'm working toward my CBE through ICEA and am also going to be going back to school to get my RN ....one of my goals is to teach in a hospital setting.

I'm a bit tired here so not sure if I'm coming across well. Sorry...

earthgirl · 11-02-2008, 01:54 PM

I state in my contract that prenatal visits do not take the place of a childbirth education series, just in case that's what they're thinking. I think many couples don't want a typical group (hospital-based) class with other couples for whatever reason. Maybe their insurance doesn't cover it, and they don't want (can afford) to pay, or maybe the thought of being with a bunch of strangers and learning about an intimate family event doesn't appeal to them. It's good to have names of independent CBE who will go to their home for "private classes". They should be wanting to know certain "routine procedures" of that hospital, or their care provider at least.