My response to concerns about leading women into disappointment over the lack of better options is "Consider the alternative." Right now, for lack of options that support and promote normal birth, women are ending up with preventable major surgery as well as other medical interventions with potential to do harm, and they, their babies, and future babies are ending up with avoidable physical and mental morbidity as a result. I believe that it is our moral and ethical responsibility as educators to give women the information they need to make informed decisions about their care, and we know--not as a matter of opinion but of fact established by the consensus of the research--what policies and practices promote optimal outcomes.

If you advertise as a class that specifically promotes normal birth, you can talk about these policies and practices, make explicit the sources on which what you are teaching is based, teach what questions to ask, and then it is up to your couples to decide what they want to do with what you have taught them. Here are some additional sources to the ones I listed in my earlier post:

Mother-Friendly Childbirth: Highlights of the Evidence

Informed Consent/Refusal

-- Henci

Let me start by saying that I like the idea of starting independent birth classes, which you could specifically advertise as being around promoting normal birth. You could build them around Lamaze's Six Care Practices that Support Normal Birth. Handouts could include Having a Baby? Ten Questions to Ask from the Coalition for Improving Maternity Services, one of Lamaze International's partners in normal birth advocacy. Even better, try to catch women before they feel locked into their decisions. See if there are any adult education venues through which you could teach a class on childbirth choices aimed at women planning to become pregnant or in early pregnancy. Don't be afraid that the options you want for women don't as yet exist. Women need to know that. As Korte and Scaer wrote in their classic book, A Good Birth, A Safe Birth, "If you don't know your options, you don't have any."

I strongly recommend seeing what you can do to promote a normal birth advocacy group. Think about starting a birth network in your community. Lamaze even has grants available as seed money. I'm willing to bet that you will find allies if you can create a center point around which they can rally, that doula, for example, lactation consultants dealing with the train wrecks, the midwife even if she is at a distance, women unhappy about their birth experiences, other childbirth educators--for several years, I co-taught a Choices in Childbirth class with a Bradley teacher.

In the interests of making an informed decision about becoming an agent for change, though, I must warn you that if you take this on, you will need those allies because if you start to have some effect, there will be a backlash. I don't mean to discourage you, but it is wise to think through the ramifications of this choice. Forewarned is forearmed.

-- Henci