Pregnant women choosing to skip birthing classes

Like most first-time moms going into labor, Jenny Bender was afraid. But she was also prepared.

She had read books. Researched online. Taken prenatal yoga classes and finished a seven-week Lamaze class. “It was still really scary and painful,” said Bender, 28, of Colorado Springs.

“But I knew what was going to come next.” She’s not part of the norm. Childbirth-prep classes have been a long-standing rite of passage for first-time mommies, who crowd in eightweek-long courses to learn traditional “he-he-hoo” breathing techniques and what to do on the big day.

But with busy schedules and Internet access, more women are forgoing traditional courses for quick-hit daylong classes — if they take a class at all.

And they’re getting more epidurals than ever before and delivering more babies by Caesarean section. Medical-intervention rates are soaring in U.S. delivery rooms. More than 60 percent of American women opt for epidurals, anesthesia injected into the base of the spine to numb sensation from the waist down.

One military hospital posted an 84 percent rate. Memorial Health System, which serves the Pikes Peak region, reported 65 percent of pregnant women received epidurals in 2006, up from 19 percent in 1994.

The combination of epidural availability, increasingly harried schedules and Wikipedia is affecting not just what happens in the labor room, but what happens in the weeks leading up to delivery.

What was once considered a rite of passage has become an “extra burden,” say researchers Christine Morton and Clarissa Hsu in the latest Journal of Perinatal Education.

Just 11 percent of pregnant women view Lamaze or similar childbirth-prep classes as essential parts of pregnancy. In 2002, about 70 percent of first-time mothers took a childbirth class, according to a Harris Interactive Poll. By 2006, that number had dropped to 56 percent.

Colorado Springs, however, bucks the trend.

“I’d say it’s still a pretty important part for most parents,” said Laura Luckett, a midwife at Colorado Springs Midwifery Center.

“We really encourage our clients to take childbirth-education classes,” Luckett said. “The more you know, the less fearful the whole process.”

Teresa Francis, a 35-yearold Colorado Springs stylist, is expecting her first baby in June and has been digesting as much information as possible.

“Whether it’s stuff I’ll actually use or not, I like to have the information,” Francis said. “The more information you’re armed with, the better.”

What about an epidural?

“Since I’ve never gone though it, I have to see what’s happening at that moment,” she said. “I’m not opposed to it, but I’m not planning on it.” (Bender, however, opted to go without.)

Memorial Health System, which oversees about 4,000 deliveries a year, offers classes on childbirth preparation, breast-feeding basics and newborn care. Classes range from one day to four weeks.

“They have not seen a decline in attendance,” said Dr. Amie Hollard, maternal fetal medicine physician for Memorial Health System. But, she added, “I do think that women are getting their education from other places.”

The only preparation that Hollard believes is lacking for many moms is pre-conception planning — preparing the body with proper diet, exercise and prenatal vitamins at least three months before conception.

“Those are all things that are actually more important than attending a Lamaze class,” Hollard said.

But outside the Springs, more women are skipping classes entirely.

The issue, says Jaime Jenett, health program coordinator at John Muir Women’s Health Center in Walnut Creek, Calif., is that women’s schedules are jammed, and they think they don’t need the classes.

“People really think they’re going to drive up and get an epidural and not labor at all,” says Jenett. “Labor and delivery nurses report they’re coming in not knowing anything. We just want them to have something so they’re more prepared.”

First-time mothers are banking on anesthesia and think they can control the whole birth process, says parent educator Ksenija Olmer, who serves as a “Mommy Mentor” for new parents at John Muir.

“Professional women are used to being in control — everything in their daily planner,” she says. “They feel they should manage their birth plan as well.”

But there’s no such thing as a “parking lot epidural,” and Candyce Warren, a labor and delivery nurse who teaches at the Walnut Creek health center, lays it on the line.

“You’re going to have some contractions,” she tells the women in her childbirth class, “before you have an epidural.”

The point, say Jenett, Olmer and her colleagues, is that baby’s coming one way or another, and parents need to be ready.

It’s not that women have become education-averse, by any means. They’re doing their research online and signing up for baby-care classes in droves.

And locally, finding the right resources isn’t difficult.

“I think it’s the perfect place to be pregnant, have a baby and raise a child,” Bender said. “Every time I turned around there was sombody telling me, ‘Oh, you should take this birthing class or this prenatal yoga class.’”

Gazette reporter Melissa Cassutt contributed to this story.

BY THE NUMBERS

4.1 MILLION

babies born in 2005

70 PERCENT

first-time mothers who took a childbirth class in 2002

56 PERCENT

first-time mothers who took a childbirth class in 2006

68 PERCENT

first-time mothers who had watched a birth on a TV reality show, typically a birth that required dramatic medical intervention

63 PERCENT

laboring mothers who had an epidural in 2002

10.4 PERCENT

Caesarean sections in 1975, when fetal monitors, which require the patient to be flat on her back, began to be used routinely

10 PERCENT-15 PERCENT

Acceptable Caesarean rate, according to the World Health Organization; any more and the risks of surgery outweigh the benefits

20.8 PERCENT

Caesarean rate in 1995

30.2 PERCENT

Caesarean rate in 2005

SECOND TO WORST

U.S. newborn mortality rate, when ranked against other industrialized nations

SOURCE: National Center for Health Statistics, Harris Interactive “Listening to Mothers” surveys 2002 & 2006