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Introduction
How do individuals who have decided to teach prenatal
classes to mothers and possibly fathers-to-be proceed to
present themselves in the most effective manner to transfer
their wealth of information to expecting parents? What are
the most significant characteristics of these mothers and
fathers-to-be to consider while teaching these classes? It is
likely that most of the parents in these classes will be adults.
Most, if not all, will be first time parents. Some will be from
a different culture with different belief systems and values
from that of the childbirth educator. They will come from
different levels
of education
or literacy and
socioeconomic
status. These
factors affect
how childbirth
educators teach
prenatal courses
and how the parents-to-be learn.
The Parent-to-Be
Before initiating teaching, prenatal educators are urged
to consider the parent learners attitudes and perceptions,
and, that some of them may be anxious and reluctant
learners. A study by Morton and Hsu (2007) revealed that
much to the educators shock and dismay, pregnant women
viewed childbirth education as an extra task or burden
that they could forego with little consequence (p. 27-28).
Mothers who worked full time, or two jobs, felt that they
did not need the classes, and therefore, expected short and
focused courses (Morton & Hsu, 2007). In addition, there
has been a shift in cultural orientation toward pain and child
birth choices that has stirred women to commit to epidural
or C-section births, and thereby seeing little need to attend
prenatal classes (Morton & Hsu, 2007). Furthermore, the
internet has given parents access to vast information accessed
from medical websites or allowed them to share experiences
with other parents from all over the world. Prenatal practices
are most effective when they utilize educators who are open
to changes that meet the demands of parents-to-be, and in
turn are called to be innovative, and adaptive to evolving
childbirth phenomenon.
continued on next page
Natsai Zhou
Childbirth Education
Effective childbirth education goals include prenatal
educators first examining childbirth educations goals as well
as their own. The overall goals focus on providing parentsto-be with prenatal information that helps them make the
right choices for themselves as well as experience a satisfying
childbirth (International Childbirth Education Association
[ICEA], 2010). Prenatal educators are masters in concepts
and theories of childbirth. Although they are the experts and
understand that these classes are important and valuable
sources for parents, it is important to keep in mind that
participants in the class look up to them as the knowledgeable professional. Yet the educators vision might not be
equally shared by all. In one study, educators expressed that
women achieving satisfying births does not only involve disseminating the wealth of information you possess, it includes
encouraging women to accept the responsibility to make
active choices (Morton & Hsu, 2007, p. 35). According
to the ICEA (2008), a prenatal teacher provides information on physiology, psychology, and sociology of pregnancy,
childbirth, postpartum, and early parenthood, as well as
skills to assist women and their support persons to cope with
pregnancy, childbirth, postpartum, and early parenthood (p.
35). A holistic unbiased approach to teaching prenatal classes
is then warranted. This holistic approach involves all aspects
of the individuals lives such as physical, mental, emotional,
spiritual, and socioeconomic. Everything is connected, the
body and its surroundings. When any one of these elements
is off balance, then the whole person is affected.
include such formats as discussions, role playing, and experiments. As the prenatal educator considers types of learning
facilitating methods, the teaching approach should be free
of bias. Morton and Hsu (2007) state that unbiased teaching
should include equal measures of scientific clinical research
evidence, beliefs of individual preference, cultural practices,
and personal experience because everyone is different.
Adult as a Learner
Since it has been established that most participants in
the prenatal classes are likely to be adults who come with
lived experiences, and have different issues revolving around
them, an andragogy approach to teaching prenatal classes
is recommended. Andragogy is a strategy that focuses on
teaching adults. Knowles (1980) conceived the andragogy
model based on the idea that adult education requires a
unique way of teaching. Knowles (1980) assumed that:
Adults are independent or self-directed learners.
They have vast experiences that can be used as a foundation to learning.
Their readiness to learn is related to the developmental
tasks of social roles.
Their time and course perspectives are immediacy of application and are performance-centeredness.
Using this model as a foundation might facilitate learning of information to adult parents-to-be, and decrease
challenges that might be faced by the prenatal educator. Adult learners come with unique characteristics. For
instance, adults feel that they need to know why they should
learn something, therefore, for them learning is based on
what they perceive as beneficial (Knowles, 1996). In addition, Knowles (1996) acknowledged that adult learners have
a deep need to be self-directing, be responsible for making
their own decisions and being in charge. Therefore, prenatal education can incorporate as much self-discovery and
involve as many options for learning as possible (Knowles,
1996).
Adult learners bring into the learning environment
a background of life experience that affects the way they
learn. Adults have a broader base of experience on which to
attach new ideas and skills and give them richer meaning.
Childbirth education activities can be designed to reflect the
skills that can actually be performed by the parents. These
activities can permit parents-to-be to be able to compare the
theoretical models with the expected experiences (Knowles,
1996). The more explicit these skills are made through
continued on next page
Parenthood
With childbirth comes parenthood, which results in
fears and anxieties of whether parents-to-be will make the
right choices about childbirth, whether to have the baby at
home or in hospital, whether the birth will be natural or Csection, and whether the baby will be healthy. Anxieties and
fears are based on concerns about risks for perinatal infections, impaired parent/infant attachment, and interrupted
family process (North American Nursing Diagnosis Association [NANDA], 2013). Anxieties and fears are also rooted
in perceived threat to physical and emotional integrity and
change in role functions (NANDA, 2013). To address these
issues during prenatal education, appropriate childbirth
education can facilitate ways of learning new ways to reduce
anxieties and fears, encourage self-efficacy, as well as assessing and strengthening coping skills. According to the ICEA
guidelines for childbirth educators, the challenge lies in
enhancing the parents sense of self-efficacy and presenting
child birth as doable (ICEA, 2010).
Literacy
Not every parent-to-be will have the same education
background. In addition, even those with high level of
education will not necessarily have healthcare education,
let alone prenatal education. In any case, no matter how
educated one is, when one is a new parent, childbirth is
new territory due to lack of exposure to the experience.
Knowledge deficit in prenatal education is not only related
to those with limited cognition, but applies to everyone, and
therefore during prenatal classes, childbirth educators have
to be careful to avoid jargon. Parents-to be will already be
overwhelmed with the unknown, anticipation, and expectations, therefore prenatal education should accommodate
continued on next page
Socioeconomic Status
Natsai Zhou
References
Baby Center. (2012). Childbirth classes. Retrieved from http://www.babycenter.com/0_childbirth-classes_161.bc
Bessett, D. (n.d.). Defining the normal pregnancy: Knowledge, emotion,
and embodied experience of women in stratified reproduction (Dissertation
in progress, Department of Sociology, New York University).
Camarota, S. (2005). Birth rates among immigrants in America: Comparing
fertility in the U.S. and home countries. Washington, DC: Center for Immigrant Studies. Retrieved from http://www.cis.org/articles/2005/back1105.pdf
Health Leader Media. (2010). Evidence-based practice and nursing research:
avoiding confusion. Retrieved from http://www.healthleadersmedia.com/
print/NRS-245879/EvidenceBased-Practice-and-Nursing-Research-Avoiding-Confusion
International Journal of Childbirth Education. (2008). ICEA position paper:
The role of the childbirth educator and the scope of childbirth education.
International Journal of Childbirth Education, 22(4), 34-42.
International Journal of Childbirth Education. (2010). Guidelines. Retrieved
from http://www.icea.org/documents/certET1.pdf.
Knowles, M. S. (1980). Modern practice of adult education: From pedagogy
to andragogy. Revised and updated. Chicago: Follett Publishing Company,
Association Press.
Knowles, M. (1996). Adult learning. In Robert L. Craig (Ed.), The ASTD
training and development handbook (pp. 253-264). NY: McGraw-Hill.
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Volume 28 Number 2 April 2013 | International Journal of Childbirth Education | 29
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