This month’s Brilliant Activities for Birth Educators idea is something that can be done both in person and in a virtual class format.  As things begin to normalize in the United States and some other places around the world, educators may be dipping their toes back into an in-person format and looking for new ideas to introduce in to the classroom.  I have even heard from a few educators that they are offering both in-person and virtual in the same class.  That really levels things up!  This Brilliant Activities for Birth Educators activity works for whatever format you are holding your classes and helps to create awareness and nurture decision making skills in expectant families.  To find all the free Brilliant Activities for Birth Educators’ ideas that have been published on the blog, follow this link.

Introduction

Variations and interventions in labor can often be a topic that is difficult for parents to process, especially if they fall into the healthy, low-risk category of pregnant people.  No one argues that there is not a need for some of the most common interventions, but  there has also been solid documentation that these interventions can be overused and also lead to additional medical procedures.  This activity creates great discussion and generates some solid questions that families want to discuss with health care providers at future appointments.

When to do this activity

After covering the benefits, risks and alternatives to common interventions, (induction, AROM, augmentation, epidural, vacuum, forceps, cesarean, episiotomy, continuous electronic fetal monitoring, etc.) week four of an eight week series,  I invite the families to participate in a “matching exercise” to connect the intervention with the frequency of occurrence in the United States, where we are located.

How long does this activity take

I allow 20 minutes total, with half that time used for parents to match the numbers with the procedures and the other half for discussion.

Materials

For my in-person class, I have large laminated cards with the procedures listed on each on, and the percentages of occurrence on another set.  Families work together and use the floor as their workspace as they move things around to make their guesses.  Online I provide a Google Jamboard with the same set of cards on one frame.  They can move them around virtually to create their guesses.  You can generate your numbers from the most recent national statistics or use information collated from your local area. Don't forget to update your stats yearly!

How to conduct this activity

After covering common interventions in labor using your favorite activity, invite families to make educated guesses on how often these interventions occur.  Let them work together to match the intervention with the statistic.  After they have made their best guesses, provide the correct answers.  Ask them to consider the rates that some common interventions occur: Are there any surprises?  Why might this be so “high” or “low”?  Is anything curious, disturbing or concerning to them about any of these numbers? Do they know how often their provider or facility uses these interventions?

How you could modify this activity

Families could work in small groups or online breakout rooms and compare answers amongst groups.  For some interventions, asking families to research what might be a suggested “appropriate” level could be interesting.  This information may not always be easy to find.  You can also provide it and discuss why there is a difference, for example between the current cesarean rate and the recommended rate.

What do families say

I have to be honest, this is a favorite activity for my classes.  They become very curious about why these common interventions are so frequently used and what it might mean for their own personal goals for their labor and birth.  They also enjoy coming back and sharing with the class any discussions they have with their health care provider on these topics.

Conclusion

It is not only important for families to have the skills to participate in shared decision making around events that might come up during their labor and birth, but to understand that some interventions may be suggested when not absolutely necessary.  They have the right to accept or decline any procedure offered and I always trust each family to make decisions that feel right for them.  They are more confident about having discussions and making decisions when they have completed this exercise.

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