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Preparation for labor and childbirth

Author
Judith A Lothian, RN, PhD, LCCE
Section Editor
Charles J Lockwood, MD, MHCM
Deputy Editor
Kristen Eckler, MD, FACOG

INTRODUCTION

A woman's experience of birth is vitally important, and her birth memories endure [1,2]. Four factors are particularly important in determining a woman's childbirth experience: personal expectations, the amount of support she receives, the quality of the caregiver-patient relationship, and her involvement in decision-making [3].

This topic will review goals and educational methods that help prepare women for labor and childbirth. Other topics relating to pregnancy are discussed separately (See "Initial prenatal assessment and first-trimester prenatal care" and "Prenatal care (second and third trimesters)" and "Group prenatal care".)

BACKGROUND

Women have always prepared for the birth of their babies. Mothers from all cultures traditionally passed their knowledge about labor and birth to their daughters. These cultural and family rituals guided women through pregnancy, labor, birth, and the early days of mothering. Much of women's wisdom about birth was lost when birth moved from home to hospital. Mothers, sisters, and other women knowledgeable about birth no longer attended the woman. Birth became a medical event and cultural and family rituals took a back seat, eventually all but disappearing [4]. The development of structured educational programs in preparation for childbirth came about as the traditional methods of information sharing declined [4,5]. Nurses and physical therapists who knew a great deal about the mechanics and medical management of pregnancy, labor, and birth, began to educate women about childbirth, largely outside of the health care system. Eventually these professionals became formally trained as childbirth educators [5]. Childbirth education focused on two things in those early years: the basic anatomy and physiology of labor and birth and simple strategies (typically relaxation and breathing) to cope with the pain of contractions.

We now know a great deal now about the role of pain in labor [6], the wide and ever increasing number of ways that women find comfort during labor and birth [7], and the importance of continuous emotional and physical support during parturition [8-10]. In addition, some traditional birth practices, such as movement during labor, physiologic pushing [11,12], and the upright position for second stage have been shown to be effective practices in controlled studies [13,14]. Women now prepare for labor and birth with much more knowledge than women did forty years ago.

GOALS OF PREPARATION FOR LABOR AND BIRTH

The major goals of childbirth education are to provide women with the ability to be [15,16]:

         

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Literature review current through: Nov 2016. | This topic last updated: Thu Oct 08 00:00:00 GMT+00:00 2015.
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