While the United States spends the most on maternity care of any other industrialized nation, many people don't realize we have some of the worst outcomes. In a World Health Organization bulletin from 2015, author Priya Agrawal states, "Although considered mainly as problems of the developing world, maternal mortality and morbidity remain a challenge in the United States of America. Between 1990 and 2013, the maternal mortality ratio for the USA more than doubled" .
It's news to many that the state of maternity care is not as positive as we would hope. The infographic to the right, created by the collaboration of Improving Birth and Evidence Based Birth, shows that the routine care most women receive in the U.S. is not grounded in evidence, and can cause more harm than good.
So, if these are the facts of modern maternity care, which is not producing very good outcomes, and most families are not aware of these facts, what are childbirth educators and doulas to do? Doulas and childbirth educators are generally the ones tasked with the job of informing parents of their rights and options in childbirth, second to health care providers, and statistics tell us they've got quite a complicated job ahead of them!
challenges facing childbirth educators
Childbirth educators currently have quite a challenging task. According to Listening to Mothers III, only "one-third (34%) of women reported taking childbirth education classes during their recent pregnancy' . This means there are many families who receive little to no preparation for childbearing and parenting, and of the parents who do take childbirth classes, not all of them truly grasp and retain the information that could be most helpful to them. The Listening to Mothers survey continues,
Concerns about women’s knowledge include:
a majority could not correctly identify two facts about labor induction
a majority could not correctly identify two facts about cesarean section
a majority identified unsafe gestational ages as the earliest safe time to deliver a baby, absent complications
despite quality concerns noted above, 47% rated maternity care providers as “completely trustworthy” and an additional 33% as “very trustworthy”
despite quality concerns noted above, 36% rated quality of maternity care in the United States as excellent and 47% as good.
Over the three Listening to Mothers surveys, respondents have increasingly supported the idea that birth processes should not be interfered with unless medically necessary. However, there was little indication that the maternity care system protects, promotes, and supports the intrinsic physiologic capacities of this largely healthy population of women and their fetuses/newborns...
Survey results point to the need for mothers themselves to become more engaged and activated and take an increased role in the challenging yet crucial responsibility to become informed, understand their maternity rights, and make wise decisions about matters that impact the health and well-being of themselves and their babies. Mothers need skills and tools to be able to take these steps forward, including improved knowledge about quality maternity care, high-quality decision aids, critical appraisal skills, and help in navigating the maternity care system .
From this, we can gather the following facts:
- The vast majority of childbearing families are under-informed or misinformed about their rights and options in childbirth.
- Childbirth educators need better skills and tools to close the information gap between those who have knowledge about maternity care and those who need it.
Improving the Tools of Childbirth Educators
As a doula and childbirth educator with a degree in education, I can attest to the fact that HOW people learn is every bit as important as WHAT they learn. The psychology of learning suggests that students learn better when various learning styles are addressed, information is adequately spaced and presented in different ways, and learners are actively engaged and motivated . This is why the Your Birth Experience Parent Guide and YBE Instructor Training incorporate exploratory activities including:
- Creating a birth vision through visual art
- Developing a birth vision statement based on the 5 Things Women Want in Birth
- Exploring personality styles needs and communication implications
- Decision-making patterns and personal biases through the Groopman Spectrums tool
Our hope is that by improving the skills and resources available to those one the front lines serving childbearing people and their families we can improve people's overall satisfaction with their birth experiences, which we know impact long-term birth memories, parenting experience, personal self-image and so much more!
Exciting New Options for Childbirth Educators
At the 2016 DONA International Conference, I connected with several colleagues who are innovating in incredible new ways. Here are some exciting new resources available to those educating expectant people and their families about childbirth:
- Down the Canal, the Game of Birth - Created by Betsy Schwartz, of BirthIntheKnow.com: This fun and educational board game offers players a non-threatening way to learn about and test their knowledge of maternity care options in pregnancy, childbirth, postpartum and breastfeeding.
See the video to the right to see the game in action!
- Labor Positions Coloring Book - based on the illustrations from Penny Simkin's Birth Partner book. The adult coloring craze is catching on, even in the birth world! Coloring is relaxing, engages different parts of the brain, and is fun for visual and tactile learners or anyone else willing to explore this learning style!
- HUG Your Baby - "Based on child development and medical literature, HUG Your Baby’s trainings and resources help parents (and the professionals who care for them) understand a baby’s body language in order to prevent and solve problems around eating, sleeping, crying, and parent-child interaction and bonding."
I hope that as childbirth professionals continue to explore new ways of learning and collaborate with one another, we can better reach the families who need this information the most and truly make a difference in their lives. If you're aware of other new resources that help childbirth educators teach and parents learn, please share about them with links in the comments!
1. Agrawal, P. (2015). Maternal mortality and morbidity in the United States of America. Retrieved from http://www.who.int/bulletin/volumes/93/3/14-148627/en/
2. Declercq, E. R., Sakala, C., Corry, M. P., Applebaum, S., & Herrlich, A. (2014). Major Survey Findings of Listening to MothersSM III: New Mothers Speak Out. The Journal of Perinatal Education J Perinat Educ, 23(1), 17-24. doi:10.1891/1058-1243.23.1.17