May 26, 2004

The future for independent childbirth education

Its been a quiet week for me - quite a change from my usual hectic pace and a nice lull before I head back to the UK next weekend. Midwifery issues also seem to be bubbling along and there have been few issues of note worthy of comment.

The childbirth education field has generated some discussion amongst some of us, however. I was asked recently by a pregnant woman on the phone for the name of an independent educator in her area. Several years ago this would have been an easy question to answer, as there was a network of educators in and around Sydney that provided community based classes. Over the past couple of years, this number has dwindled and now it is almost impossible to provide a contact for most part of Sydney.

The demise of the independent educator is an interesting phenomenon, caused no doubt by several underlying causes. One major reason for their move out of this area of interest has been the difficulty in attracting clients, which poses risks for the viability of their (very) small businesses.

Hospitals, who are routinely unable to provide enough classes for their own clientele, could refer to community based programs, but usually fail to do so. One likely reason may be that booking clerks in the maternity units and other involved hospital staff are unaware of the programs available elsewhere. Better communication, publicity and collaboration would solve this problem.

Another reason for lack of referral may be suspicion about the content of these programs, especially as many are perceived to be “anti hospital” in their message when really they are just advocating for consumer rights and informed choice. Some of the educators that I know have been active in the community are fairly “invisible” within wider maternity circles (for example, they don’t attend workshops or seminars where they could meet with midwives) and this may contribute to their isolation, and perhaps misunderstandings about their role.

Some hospitals have been reported as actively discouraging referrals to programs outside the hospital setting. This is nothing new, of course, as I can remember 20 years this was the case in the northern suburbs of Sydney (a very affluent area). These behaviours are usually instigated by the doctors, who want to restrict information given to parents so that awkward questions can be avoided and policies will not be challenged. There is a suggestion that in one area of Sydney the directive to not refer parents to “outside” classes has actually come from the Parenthood Education Department itself, perhaps because they resent the quality of the programs on offer elsewhere or again because of internal pressures from doctors.

Community based classes offer the best chance for parents to gain unbiased, comprehensive, consumer orientated in formation in an appropriate adult education setting where individual needs can be met. Setting up these programs takes initiative, perseverance, effective networking and good marketing. The rewards are there for the successful educator, but it takes time and energy and rarely offers enough financial reward to make it a viable career choice in itself.

I hope that the role of these educators can be preserved. In a similar way to that of home birth in relation to hospital birth, they keep birth education “honest”, maintaining high standards and offering real choice to expectant parents. Many of the childbirth groups that once flourished have now disappeared as a result of a lack of volunteers, the changing roles of women in our society and the perception that paid work is more necessary/fulfilling/valued by society. Many independent educators would have once aligned themselves with such groups, either as casual employees or in collaborative referral arrangements. Now, they are being forced to work on their own and they must make extra effort to stay in the loop - with parents, with maternity care workers and with hospital departments. Having spent many years in this role myself, working from home and loosely aligned with other educators across the city, I know that this work is important and very necessary. Parents have a right to an independent view and unbiased information.

Posted by andrea at May 26, 2004 04:13 PM