Course Outline

Childbirth Education Course

This is the “standard” course offered by Parents Centre & taught by a Childbirth Educator.                                            

Duration of course: minimum of 12 hours (but preferably 14 hours or more), usually over 6 to 9 weeks, depending on whether an Early Pregnancy Course has been run. Weekend, block or ‘intensive’ courses may also be run according to the expressed needs of pregnant women.

Topics a,b,c d would be excluded if these had been covered in an Early Pregnancy Course. Topics e, f, g may have been included in an earlier course, but are of such importance that they would need to be repeated.

a)  Foetal Development

• Developmental stages of the foetus
• Description and role of the placenta
• Effects on foetus of drugs, alcohol and smoking
• Information on available smoking cessation courses

b)  Prenatal Care

• “Routine” tests and their significance
• Options in childbirth, caregiver, and place of birth
• Visits to caregiver, including birth plans, communication, seeking second opinion, issues surrounding informed choice and consent
• Special tests, including ultrasound scanning, electronic foetal monitoring
• Possible pregnancy problems, including signs and symptoms

c)  Nutrition

• Relevance and importance of nutrition in pregnancy
• Increased nutritional needs in pregnancy and ways of ensuring these are met
• Nutritional means of reducing pregnancy complications/discomforts
• Dental care in pregnancy

d)  Physical and Psychological Needs

• Changes in the mother's physiology/pregnancy discomforts
• Psychological/emotional changes arising out of physical changes, changes in lifestyle and circumstances, changing sexuality, relationship changes

e)  Pelvic Awareness

• Description of the pelvis. Exercise to demonstrate how the pelvis moves and positions useful for increasing the size of the outlet
• Overview of pelvic organs
• Description of the pelvic floor: the muscles, their shape and the significance of this shape
• Pelvic floor exercises and perineal massage
• Optimal foetal positioning

f)  Relaxation - interwoven

• Demonstrate breathing awareness as a relaxation technique. May include visualisation, progressive relaxation - optional
• Discuss relaxation as a life skill and it’s use in labour
• Enhancing relaxation during Labour by modifying the environment; role of support people; positions for labour and birth
• Use of massage and touch; water and heat

g)  Stretching and Exercise

• Benefits and cautions of stretching in pregnancy
• Warm-ups and basic stretches
• Posture and back care
• Stretching to include the way the out breath is used in labour
• General exercise

h)  Pain

• The physiological and psychological aspects of pain in labour
• The role of pain in labour
• Ways of making pain more bearable
• Use of stretching exercises to illustrate these points

i)  Description of Labour

• An overview of the complete labour/birth process.
• A more detailed description of normal labour and its variations should include:
  • Signs of impending labour
  • Onset of labour
  • First stage patterns
  • Birthing behaviour and emotional responses
  • Admission procedures if appropriate
  • Monitoring of mother and baby
  • Second stage and birth
  • Third stage
  • Initial contact with baby
• Many of these topics maybe integrated and taught together

j)  Drugs, Obstetric Procedures and their Alternatives

• Informed decision making and consents
• Alternative methods and self help techniques
• Common obstetric procedures: risks/benefits/alternatives
• Description of drugs used for pain relief: risks/benefits/alternatives

k)  Breastfeeding

• Benefits of breastfeeding (not pros & cons)
• First contact with baby – the importance of skin to skin
• Positioning the baby at the breast
• Physiology of lactation. Supply = demand, let-down reflex
• Possible early challenges: sore nipples, engorgement etc
• Supplementary feeds, conflicting advice
• Mother’s nutritional needs while breastfeeding
• Local breastfeeding resources and support available
• BFHI & the 10 Steps to successful breastfeeding
• Contraception for breastfeeding mother

l)  Postnatal Issues

• Lochia, third day blues, ‘after pains’, rooming-in, demand feeding, early discharge, care during the immediate postpartum period, conflicting advice
• Newborn appearance, care of the newborn, circumcision if appropriate
• Vitamin K, jaundice, Guthrie test, neonatal intensive care, vaccinations, baby with special needs
• Safe Sleeping – co sleeping, head shape, sleep positions, mattress wrapping

m)  Early Days at Home

• Ideas for coping in the first few weeks, including self-care
• Tiredness, reassessment of priorities, simplifying housekeeping
• Clear communication
• Sexuality and Contraception - variation in needs and desires, importance of communication

n)  Unplanned Experiences

• There are many aspects to this topic and it should be woven into the classes wherever possible. Outcomes that should be included are: 
  • Unexpected obstetric complications Postnatal Depression/PTSD
  • Sick or premature infant High/special needs babies
  • Stillbirth Any experience that does not match
  • Cot Death circumstances
  • Discussion on grieving and ways of coping in these circumstances

o)  Well Child Care

• Entitlement to universal well child care
• Options in well child providers

p)  Optional topics

• Infant CPR –using a qualified tutor
• Infant car seats – in brief or using a qualified tutor to demonstrate 
• Signs and symptoms of Illness, when to call the doctor
• Postnatal Exercises
• Community Support
• Practical Parenting
  • Infant equipment & products
  • Nappies
  • Infant clothing
  • Baby bathing
  • Infant massage
  • Bedding – Cot Death & safe sleeping must only be taught by a CBE
  • Breastfeeding related matters – these can only be included when a CBE facilitator is used

Additional or Supplementary Courses

Additional courses or services may be offered in conjunction with or additional to the “standard” CBE course. The following are examples of these.

Early Pregnancy
 
Duration of course: usually held over two to three sessions.

a.  Information on:

• Promoting physical, mental and social wellbeing of the mother
• Dangers of drugs, alcohol, smoking
• Foetal development
• Positive and realistic approach to pregnancy and birth
• Nutrition
• Miscarriage and grief

b.  Options for choosing caregiver and place of birth

c.  Discussion of myths surrounding pregnancy and childbirth

d.  Antenatal care, including tests, terminology etc

e.  Pelvic awareness and stretching exercises, including posture, pelvic floor exercises

f.  Breastfeeding with overview of expectations of normal

g.  Options in childbirth

h.  Layette and equipment for baby

Stretching
 
Duration of course: usually open group with women joining the class throughout the year.

a.  Information on:

• Anatomy and pelvic awareness
• Benefits and cautions of stretching
• Importance of good posture
• Back care during pregnancy and postpartum period
• Benefits of pelvic floor muscle exercises

b.  Practical exercises and demonstrations relating to the above topics

Refresher Courses

Duration of course: minimum of 4 hours, usually over 2 to 4 weeks. Weekend or block courses may also be run according to the expressed needs of pregnant women.

a.  Discussion and sharing of previous experience/expectations

b.  Options in care and place of birth

c.  Stretching

d.  Breathing awareness, relaxation

e.  Revision and practice on first and second stages of labour

f.  Breastfeeding: previous experiences, resources etc

g.  Postnatal issues, including community resources 

h.  Changing family dynamics, including coping with toddlers, sibling rivalry

Teaching Resources
 
To enable the Childbirth educator to vary her teaching and presentation techniques, a range of resources will be necessary. The extent of these resources will vary from Centre to Centre according to circumstances may include most of the following:

• Videos about PCNZ, childbirth, breastfeeding, the first few days after birth, CPR, child safety
• Audio tapes
• Mats, pillows, chairs
• Pelvis and doll, knitted uterus, placenta 
• Whiteboard, blackboard, OHP
• Charts showing foetal development, presentation, labour, the newborn, breastfeeding 
• Pamphlets on a variety of topics such as caesarean section, infant feeding, resource personnel, community groups as recommended by Parents Centre
• Books and texts: Preparing for Birth 
• Well stocked library about birth and parenting