Any antenatal teachers, childbirth professionals etc. Bit of a WWYD?

[FaustWithAFlipChart]

Not sure whether I'm posting this in the right place. Am a namechanging regular and probably fairly obvious.

This is a bit long so bear with me...

I'm in the US and training as an antenatal teacher. I'm a big advocate for choice in birth.

With the organisation I've trained with (ICEA), I need to have 12 hours of evaluated teaching time in order to certify. I can teach without being certified but obviously, it's nice to have certification. This is fairly standard for Lamaze and the other big groups who have certified educators.

Now, there's really not many people around in my area to do the evaluation so I had given up on getting certified until I ran into a woman who is a hospital educator. She has kindly 'taken me under her wing' and invited me to observe her hospital classes and I think the idea is she'll let me teach part of her class and then I can get the certification.

The problem is, her classes make me want to cry. They seem so totally at odds with my philosophies and she admits that the hospital control her curriculum almost entirely. She isn't allowed to mention home birth or birth centres as an option and has to support hospital policy.

Let me give you an example. One woman was opting for a caesarean and was deeply upset about having her arms taped down to the table. (Part of the standard hospital policy).

My mentor didn't suggest the woman could ask her doctor about this or ask whether there were any alternatives. (Pretty sure you can request this doesn't happen in a birth plan, although doctors aren't keen on it.) She just said, "Yes, that's what happens."

In another class, she stopped the independent tape she was showing on pain relief and had to play the hospital's tape on epidurals which was very pro-epidurals, describing them as safe, glossing very quickly over the risks and saying women should be 'realistic' because birth is very very painful.

She is also acting against ICEA's guidelines which state quite clearly that the educator must work in a place where she has freedom to teach all alternatives.

I think she's pretty uncomfortable with the situation herself but needs the steady employment.

I don't know what to do... do I keep my mouth closed, go along with it and get my certification? Do I give up on certification and just quietly teach my own little classes dealing with home and natural birth? Do I talk to her about it and probably piss her off by showing her the ICEA guidelines?

I'm thinking of starting on the process towards Birthing from Within certification which is more spiritual. But that takes a while and is not quite as 'professional' as ICEA.

Would just welcome some thoughts

[ScaredOfCows]

I'm an ex midwife in the UK. Over recent years, the antenatal classes we gave were very tightly controlled by the 'Trust' we worked for, down to being allocated a certain number of minutes for each topic, so for example, 8 - 10 minutes to discuss events after the birth. We were told to gloss over epidurals, not give opinions and if women asked for further information, to avoid giving answers. We also had to do the class with a second person in attendance, usually a maternity support worker, to ensure things ran to plan. The management would ask them periodically about the class structures.
The results were that many midwives hated having anything to do with antenatal classes, and the women were frustrated and let down by not getting the classes they wanted or needed.
I would say that if observing these classes allows you to get the certificate you need to then go and facilitate the type of classes that would be useful to women and that you would enjoy, then you should bite your tongue and do it.

[FaustWithAFlipChart]

Thank you Scared.

It's nice to know I'm not alone in this dilemma, although so worrying to hear that hospitals in the UK also support their own policies over women's choices.

I do have the option of teaching without certification - in fact most US organisations encourage getting lots of experience teaching before applying for certification. But I know certification would boost my credibility.

I'm trying very hard to bite my tongue but I'm desperate to grab all these women after the class and say, "Look, ask your doctor if you have to do that. You DO have a choice here."

[ScaredOfCows]

On a slightly more positive note, you could look on it as good experience to see how things are done - probably out of necessity by this particular educator - at hospital classes, what information the women are given, and to get a general 'feel' for attitudes towards them.

It will all help you to become a better facilitator in time. In reality, many women do have a really crap experience of antenatal classes, antenatal care and labour care, and that is what you have to work with. So seeing it at first hand, and listening to this educators reasoning will really help you to understand what the environment is and how to empower women to get the experience that they want.

[FaustWithAFlipChart]

Absolutely! I'm astounded at how much I've learned in the classes I've sat in on so far.

For instance: They give epidurals at 9-10cm at this hospital, primarily for customer satisfaction, so women can go away happy because 'they got their epidural.'

head on desk I have my work cut out.