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What to Expect in Childbirth Classes

woman holding pregnant stomach

As a relatively new mother of one, I won't be the first (and certainly not the last) to tell you that when it comes to having a baby, nothing can duplicate the actual experience (not that you'd really want a dry run of labor anyway!). However, a little education can go a long way in boosting your confidence and dispelling the many myths about Labor Day.

That's where childbirth classes come in: They're as close as you're going to get to giving birth, so it's well worth your while to attend. Most moms-to-be opt for classes at their ob-gyn's hospital of choice, and some take private sessions run by independent educators. But every student will leave class wiser (and perhaps a bit queasier), better prepared for the big day ahead -- moms and dads alike.

This was true for Gary Weisserman of Royal Oak, Michigan. "I needed the information for my own peace of mind. I can't even imagine, for instance, if I had gone in blind and then found that the ob-gyn is only in there for the last few minutes. I would've been going crazy!" says Weisserman. Though the class is a big time commitment, it's one of the most interesting courses you'll ever take, and everyone gets the best grade of all -- a beautiful new baby.

School Days

Around the seventh month of pregnancy, it's time to grab your pencils, books -- and your partner -- and start class. Most hospital courses run about two hours per class for four to six weeks. There are also weekend classes that compress all the information into two days. Classes cost about $60 to $100. You'll share your class with 10 to 15 couples or more, depending on your particular hospital. Fortunately, most of them will be first-time parents, so you won't have to worry about any know-it-alls shouting out the answers.

These courses are usually taught by someone who experiences birth every day: a labor-and-delivery nurse who's certified in childbirth education. If a hospital instructor isn't an RN, she's almost always a certified childbirth educator. And chances are, she's thrilled to educate you about this momentous event -- not just lecture you on biology.

"Anyone who is teaching these classes got into it for her love of birth, women, and children," says Connie Kishbaugh, president of the International Childbirth Education Association (ICEA). By the end of my own class, my teacher had gotten me so excited that I wanted to have the baby that day.

Though most births last 24 hours or less, that day will likely be packed with so many experiences -- physical and emotional -- that you need a six-week course to cover them. Here's what you'll learn.

The Biology of Labor and Birth

If high school bio made you nauseous, hang on to your seat. Your instructor will cover labor and birth from start (it's thought that the fetus sends a chemical message to the mother's brain, which gets the process going) to the delivery of the placenta (a one-and-a-half pound organ that looks so big, you won't believe that it and a baby could fit in your body).

In detail, your instructor will describe the thinning and opening of the cervix, the three stages of labor, and delivery, including what you'll feel, when, and why. For example, very early labor contractions can be so mild and so infrequent, you may feel like you're having mild menstrual cramps every 45 minutes. Your teacher will also detail how the baby descends from the pelvis to the birth canal, and the different ways babies present themselves at birth; some come out headfirst, facedown; others come out faceup.

Though it may seem like some of this falls into the too-much-information category, "it makes you feel like you're more a part of the labor instead of an outsider looking in," says Theresa Rudder, a childbirth educator at Mount Sinai Hospital in New York City. And knowing what's going on in your body will help you feel more confident and in control.

During this portion of class, you may be shown a video of an actual birth -- not a PG-13-rated version, either. Not surprisingly, some people choose to use this time to take a bathroom break.

Pain Management

How much will labor hurt? It's probably the biggest question on the mind of the first-time mom. To answer it, childbirth classes go over everything modern medicine has to offer -- epidurals, analgesics, narcotics -- and discuss the pros and cons of each pain-relief method. Epidurals, for instance, are very effective at blocking pain, but they can make it tougher to push out the baby. Your hospital class may also cover alternative pain-relief methods, such as breathing techniques, visualization, or massage. (In general, the more medically focused the hospital, the less you'll learn about nondrug pain-relief methods.)

A class that emphasizes natural methods will run down different laboring positions that can help relieve pain and make labor progress, such as sitting on a birthing ball or in a warm bath.

Troubleshooting Complications

Unfortunately, not every labor is completely uneventful, so your instructor will go through the most common labor and delivery issues, along with their resolutions. If your labor stops progressing, for example, your doctor may have to give you a drug called Pitocin, which can cause intense uterine contractions.

And if your baby is having trouble fitting through your vaginal opening, doctors may have to cut it, a procedure called an episiotomy. Your instructor will also talk about c-sections: the events leading up to one, such as fetal distress, and what happens if you have to have one. It all sounds scary, but most of these procedures are routine, and your teacher should be able to answer any questions or concerns you may have about them.

Though you will listen to lots of lectures, childbirth classes usually feature some lighter fare as well. A hospital minicourse -- complete with the admissions process, the policies on everything from visiting hours to whether or not baby can room in with you, and a nursery visit -- is an enjoyable part of class.

Some instructors may treat you to a prenatal workout. They'll teach you stretches to alleviate pain and pressure from typical problem spots such as the back and pelvis. The more creative types have been known to add in a few fun interactive elements. "My teacher had my husband strap a 30-pound backpack across his stomach. Then she made him tie his shoes," recalls Stacey Cohen of Chicago.

No class is complete without recess, which will give you time to bond with other couples during breaks. In childbirth classes, indigestion and shrinking bladder size are the stuff of which lifelong friendships are made. "It was actually nice to have all those couples there and to hear the questions they had and to hear about what they were going through," notes Cohen.

Ultimately, when you graduate, you'll have a lot of knowledge, a big boost of confidence, and a few new friends to call when your bundle of joy arrives.

If the idea of spending any extra time in a hospital isn't for you, you may consider signing up for a private course. These classes are usually held in an informal setting such as someone's living room or a church. Most instructors are certified childbirth educators, but the quality of certification varies; basically, anyone who took a two-day or a two-year course can call herself a childbirth educator, so be sure to ask for her credentials if you go this route.

She should have certification in a particular childbirth preparation technique, such as Lamaze, or from ICEA or the Association of Labor Assistants and Childbirth Educators (ALACE). These classes are more expensive, $50 to $350, but they also tend to go into more detail than their hospital counterparts, exploring alternative birthing methods and pain-relief techniques that don't involve medications.

These courses are usually smaller than hospital classes, around eight to 10 couples. "The small numbers make it easier to share with the others," says Karen Pestlin, director of teacher training for ALACE.

Though this intimacy is great for some, others find the setting too informal; a common complaint is that there can be too much sharing and too few facts about what's going to happen. Ultimately, the choice is yours.

Leigh Balber, a mother of one, is a writer based in New York City.

Originally published in American Baby magazine, September 2004.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.