I am currently in my 21st week and would like to know when to sign up for a Lamaze class?

As soon as conveniently possible because classes fill up. You can find the closest Lamaze-certified educator here. For more general info on the Lamaze website helpful for expectant and new parents, go here.

-- Henci

I am 10 weeks pregnant with our 4th baby, our first birth was rough with an induction & many interventions, my second I had a group of midwives but was able to deliver vaginally frank breech with an OB but the birth seemed unnatural with a large crowd of nurses and hospital staff then our healthy baby swept away for "observation" and our third was a terrific homebirth.  Our health insurance will not cover homebirth or a birth center birth and we cannot afford to pay for a birth out of pocket.  We will be delivering at a small hospital with the same group of midwives we had our second time around, would I benefit from Lamaze courses?  My last two births were unmedicated, I am a little nervous about going back into the hospital setting though.  Any suggestions for me?

Having had two unmedicated births, I'm thinking you know how to cope with labor just fine. It sounds like your issue is more making sure you are making informed decisions. For that, the acronym "BRAIN" can help. Barring an emergency, if any test, drug, procedure, or restriction is proposed, consider:

B enefits
R isks
A lternatives, including doing nothing, and the benefits and risks of those
I nstinct or intuition, i.e. what your gut is telling you
N o or not now, i.e. your right to informed refusal

Again, barring an urgent situation, ask for time alone to consider before making your decision so that you don't feel pressured.

My book, the Thinking Woman's Guide to a Better Birth, is aimed at helping women make decisions based on what the research evidence establishes as safe, effective care. It is getting long in the tooth, but the information in it is still sound. Other books that might help you have an optimal hospital birth include Pregnancy, Childbirth, and the Newborn and The Lamaze Guide: Giving Birth with Confidence.

If you have some discretionary money, you may wish to consider hiring a doula. Many have sliding scale or will take time payments or possibly even barter. A doula offers emotional and physical support. She is in your corner. The best known of the doula organizations is DONA International. Come to that, before giving up on home birth with a midwife, see if your prior midwife or another qualified home birth midwife in your community will do the same.

~ Henci