Re: 'educated' women

[Nikki Macfarlane]

Debby,   You rightly point out one of the dilemnas of childbirth education - how much do we teach and what perspective do we teach from? How on earth to get across the myriad of information so women can make truly informed choices?   If we tried to teach even a tenth of all the possible things that could happen in their pregnancy, labour, birth, postpartum or with breastfeeding, it would take hundreds of hours of childbirth education or piles and piles of brochures. Then the problem that all women you are working with have a different knowledge base to start with, a different level of interest and motivation, and a different capacity to absorb and understand the information. So how do we tackle it at all?   I work at this from two perspectives. Firstly, teach NORMAL pregnancy, NORMAL birth, NORMAL neonatal issues, NORMAL breastfeeding. For example, I don't talk about pain relief options. Why not? Because my clients do not need me to cover anything they can read for themselves in a pregnancy book or a women's magazine. We talk about pain. How pain is normal. Why labour hurts. What it is telling us. How will it benefit the woman and her baby. How she has everything within her capacity to deal with it. How her body will utilise amazing hormones to work with her pain. How she has so many options available to her to help her deal with it. Pain is normal. Labour will hurt. I don't try and talk about ways to make it go away. I do the same with normal labour. I don't talk about fetal distress. Only one women in twenty that I teach might even experience this problem. So how do I make sure that if she is the one in twenty that she has some way of making informed choices?   This is the second aspect of my classes. I teach her skills that she can utilise in ANY situation where labour does not take the path she had deemed the most optimal one. Decision making tools. Questioning and communication tools. Techniques for determining the type of caregiver she had chosen and how to go about exploring other options if she decides she has the wrong one for her needs. These skills are not only helpful for gaining further information when a doctor tells her he thinks her baby is in distress. They will also help her to explore her options if she has gestational diabetes diagnosed. Or her membranes rupture before the onset of contractions. Or if her labour is not progressing as quickly as her caregiver would like. Or her baby is thought to have jaundice and the caregiver has suggested testing. Or if she is experiencing problems with breastfeeding. Or even 5 years later when she is trying to resolve a problem with her son or daughter related to their school classroom. TRhese are life skills. They are not unique to labour. They do not require a massive accumulation of knowledge on every single possibility.   Teach simple tools that develop skills for communication, decision making and questioning. Teach effective listening techniques by example. Teach assertiveness by example. Really beieve in what you teach and then practice it yourself. Your clients will follow your lead - not every time but for those who are in a place on their own journeys where they are ready to do so, they will see your example of "walking your talk" and develop those same skills themselves.   A long way to not say very much I think!   Nikki Macfarlane Singapore   ----- Original Message ----- From: Debby M To: [EMAIL PROTECTED] Sent: Sunday, May 12, 2002 5:40 PM Subject: Re: 'educated' women I consider myself an educated woman.  Two degrees and post graduate studies would certainly indicate such however it is only since the birth of my first child that I came to realise how difficult it is for a medical lay person to obtain information that truely allows them to make an informed choice.