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We all have our reasons for wanting to become childbirth educators and/or doulas.  Most of us have gradually discovered a passion for all things related to pregnancy and birth.  Sometimes some of us are fortunate enough to know which path to take and how to reach our goals-and other times it can be a bit overwhelming.  Which organization should I certify with? How long will it take? Will I make any money? Will I be a good teacher and where can I find pregnant couples who would be willing to learn from me? Will I have the time? Can I find a someone to mentor me? In the end it becomes clear that one need only trust and be open to what unfolds...

This is one woman's story about her path to becoming a childbirth educator.  The letter was written in response to an inquiry about the certification process.  I am sure you will find that your story resonates on some level with Dolly's and if not-she does give some excellent advice.  

Thank you Dolly for all that you do to inspire and educate pregnant couples and your words of wisdom for those of us who are either on the certification track or who are giving it some thought.

My name is Dolly Wagner and I am on the Board of Directors for ICEA. I was delighted to read your email inquiry about becoming a Childbirth Educator. Here is my story and suggestions. My BS degree was in Physical Education so I had a good background in the sciences. I became fascinated with pregnancy and birth process with the birth of our first child. Our childbirth instructor encouraged me to consider becoming an educator. Once I decided not to return to teaching in the public school system, I started observing classes, reading and working with some OB nurses. Under the guidance of my original instructor, I was teaching one night/week within six months. What a great way to combine two of my passions - teaching and childbirth! These classes were held at the Technical College and not affiliated with any hospital, HMO, or group of doctors. There was no certification requirement to be an instructor.

Money was tight because I was a stay-at-home mother. I became an ICEA member, and used their Journal and resources to keep information up-to-date. After teaching for a couple of years, I felt compelled to get my certification. I didn't want people thinking all it took to do my job was send in two boxtops and 50 cents, and presto you could teach others. So I started with the Basic Teacher Training Workshop and had many of teaching techniques I used validated and learned many more useful ideas. The Workshop really primed me for the certification process. It does take work and commitment. I am proud to say that this Fall, I will have been teaching Childbirth Classes in the Madison, WI area for 31 years. Presently I teach 2 - 4 classes per week.

I can not say that I have gotten rich doing this but it has brought me a great deal of personal satisfaction. Here is what I have seen as advantages:

• allowed me to stay at home with my children
• the salary is a lot more than if I worked at Target or McDonalds
• stimulated me intellectually and kept me in touch with adults
• people are coming to class anticipating an exciting life change
• I get to teach life skills - good nutrition, exercise, relaxation, breathing and stress reduction
• it is challenging to keep lessons fun, practical, and up-to-date
• I have quite a few foreign grad students in class so I need to be culturally sensitive
• my lessons include discussions on feeding, newborn care and parenting concerns
• empower these expectant families to find answers to their questions - informed choice based on knowledge of alternatives
• my husband was very involved with raising the children - feeding supper, baths, homework, balancing sports and other activities (he was awesome!) 
• I did a lot of volunteer work and found another part-time job when the kids went to school
• served on a number of birth-related committees

Disadvantages:

• worked nights and weekends to teach classes
• no benefits or insurance that you might have with a full-time job

Consider checking around for teaching opportunities. To actually start your own business after certification will prove to be costly. You would have to find a space to hold the class and buy teaching aids like the pelvis, birth doll, charts and DVDs for birth and parenting that are very expensive. If there is already a program or you have access to resources, that might be a place to start.

• If there is a midwife in your area, get in touch with her. Does she offer classes to her expectant parents? Maybe you could work a deal with her - you might promise to teach so many couples in exchange for some financial backing. I'm sure she has books that you might use. You will need to observe some births - would she allow you to attend?
• Check with the hospitals in your area. Many of the bigger hospitals are in the process of becoming a Magnet Hospital - which requires their staff and educators to be certified. They may have some funds to allocate to those people for certification. Try not to align with a hospital that only wants its educators to teach about birth "their way".
• Where else are classes taught in your location - HMO, a group of doctors, Parents' organization, YMCA, a business that focus on families and children? Are they looking for another educator? Remember educators do move, are sometimes overburdened, and at some point retire. Do some homework.
• Is their another childbirth educator in your area that will mentor you? If you let me know where you live, I will ask ICEA to check their records for a member that might live in your area.
• Is there a need for private in-home classes or check to see if there is a need for private classes for couples in the hospital dealing with pre-term labor?

Economically times are tough, but people are still having babies. They deserve to know about the birth process and be informed about the choices they have. Good educators are always in demand. This field needs new blood and enthusiasm, please consider sharing your passion. We at ICEA are here to support you. Taking a Childbirth Educator Workshop would jump-start the process.

Why a Vaginal Birth After Cesarean should be a Vital Option

My second birth as a student doula was with a woman who was attempting to have a vaginal birth after Cesarean.  She had spent a great deal of time preparing.  Bradley Method classes, a doula, and an obstetrician that was willing to “let her try” to give birth vaginally. 40 weeks came and went-and her doctor started talking about an induction.  Wanting to keep things as low-risk as possible my client tried all sorts of natural induction methods, however at around 41 weeks she found herself in triage awaiting induction.  They had talked of pitocin but her cervix was not favorable.  I remember it so clearly-induction points, clary sage oil, me at her feet, sister at her right hand and partner at her left.  We were going to force her cervix by sheer will into submission. 

Hours had gone by and twenty births later I have yet to see the pitocin dosage reach higher levels.  I was so new to it all but I remember thinking they sure were giving a lot of pitocin to a woman attempting a VBAC-if the main fear was uterine rupture why were they pressing that button so often?  This woman was in a great deal of pain-the contractions were intense and she tried so hard.  Semi sitting in bed (continuous fetal monitoring), rocking back and forth with our heads together –25 plus hours later her cervix remained at about 8 1/2 -9 cm and she had a repeat cesarean.  Her bladder was nicked in surgery and she ended up with a blood transfusion as well.  Both the mother and baby are healthy but her attempt at a vaginal birth had failed.

Flash forward-a few months and a few births later.  Second pregnancy-first was a Cesarean in London-this time she was going vaginal.  Her husband was out of town so the birth team consisted of myself and my doula mentor.  Labor started on my way home from another birth.  My doula mentor came and picked me up after only a few hours sleep.  We arrived at our client’s house and we labored.  We stayed at home for as long as possible and left for the hospital in the morning.  When we arrived she was in active labor and they skipped the normal admittance procedures and assigned us to our room where we labored some more.  It was amazing-the energy, the vibe, the movement, the flow-they left us three women in the room to our own devices where we just let mom and her baby do their thing.  Not only was I in the presence of my first VBAC-I was experiencing my very first natural birth.  I am still in awe.  Her VBAC was a success!

Having a VBAC is a bit different than having “just “ a vaginal birth.  There are some things you should know-for instance, why was a cesarean performed the frist time and what can you do differently. And at the same time there are similarities in terms of how you can prepare -eat healthy, exercise, get a doula, work with and understand your feelings about giving birth-find a way to explore your fears-trust the process and gather a team that can help create a healthy, positive energy around you and your birth.

Repeat Cesareans should never be routine - major abdominal surgery takes a great deal of time to recover from and it is not without risk.  In addition it is unethical for hospitals or doctors to institute bans against VBACS either formally or informally and goes against the concept of informed consent.  Although cesareans can be and are medically necessary at times-the old adage “once a cesarean always a cesarean” no longer applies – a woman has a choice and she should not be bullied in either direction-the choice is hers. I had planned to go into the history of Cesareans and VBACS but that information is easily accessed-this is about the experience itself-the importance of a woman wanting to do things her way-the way that feels natural to her.  Asking why would anyone want to attempt a vaginal birth after a surgical birth is the same as asking why a natural birth instead of a medicated birth or why a homebirth instead of a hospital birth. It’s all about choice, personal preference. 

All a woman need do is a little research-the evidence is out there-why is the option of a VBAC a vital option? According to Ina May Gaskin in Spiritual Midwifery she “continues to recommend VBAC to most women who have had a previous cesarean” because looking at the risks of elective repeat cesarean, we have the following:

            More respiratory distress in babies from iatrogenic prematurity and wet lung syndrome

            Accidental laceration of the baby (two to six percent of cesareans in some studies)

            Higher infection and injury for mothers

            Higher risk if maternal death (two to four times that of vaginal birth)

            More complications in future pregnancies, including placenta previa (seven times the risk after just one cesarean),            

            Placental abruption (three times the risk), various degrees of placenta accrete (25 times the risk) and ectopic pregnancy.

In addition research has shown:

            Babies born vaginally are usually born when they are ready, rather than prematurely by surgery

            Babies born through the birth canal have the benefit of a surge of catecholamines, which are essential for survival

            Babies born through the birth canal are more likely to be born with healthy lungs

            Babies born vaginally have higher Apgar scores

            Babies born through the birth canal enjoy early, frequent contact with their moms

            Babies born vaginally are much more likely to be breastfed and to be nursed for a longer period of time

The fact is - as evidenced in the first birth story-not everyone who attempts a VBAC will be successful-some women who do everything “right” will end up with a repeat cesarean and some women will have more luck.   The key word in the entire discussion surrounding repeat cesareans and VBACs is option.  Current research has shown that over 86% of women who have had a previous cesarean can have a subsequent vaginal birth.  It is our job as consumers, advocates, mothers, and women to make sure no one is standing in her way.

Some excellent resources:

The VBAC Companion: The Expectant Mother’s Guide to Vaginal Birth After Cesarean

By, Diana Korte

http://mothering.com/cesarean-vbac

*This blog is part of the ICAN Blog Carnival on the importance of VBAC-check out the link to see the rest

http://blog.ican-online.org/2010/03/08/vbac-blog-carnival-why-is-vbac-a-vital-option/

There are so many amazing blogs out there that pertain to topics we love-pregnancy, birth, doulas, informed choice, breastfeeding, childbirth educators, parenting-its nearly impossible to keep track.  I have decided that every so often I will post a list of blogs you should be following.  I look forward to your comments and suggestions-chances are I will miss out on a great blog or two so if you know of a blogger worthy of our attention-please let us know.  Here are some of my favorites...

Happy Blogging!

Our Bodies-Our Blog - www.ourbodiesourblog.org/blog

Science & Sensibility - www.scienceandsensibility.org

Citizens for Midwifery - cfmidwifery.blogspot.com

Peaceful Parenting - www.drmomma.org

Birth Activist - www.birthactivist.com

Childbirth Connection’s Transforming Maternity Care project collaborated with industry leaders and stakeholders to set a vision for a “high quality-high value maternity care system.”  In order to implement this vision workgroups were created to establish a Blueprint for Action.  An Action Community has been created to bring together individuals, birth advocates, care-providers, and consumer groups

This 2020 Vision was generated in response to “poor national performance on widely recognized maternal and newborn indicators, gaps between practice patterns and lessons from best scientific evidence, and unwarranted costs. It advances the core health care reform aims of improved quality and value within a major sector of the health care system.”  Specifically some of the issues that inspired this project are; procedure-intensive, costly care for a largely healthy population, overuse of many practices, associated with harm and waste, underuse of beneficial practices that would improve outcomes, many indicators that have been moving in the wrong direction and a poor showing in comparison with many other nations.

The Vision Team included experts from a wide range of disciplines including, childbirth education, community/public health, consumer and employer advocacy, family medicine, general obstetrics and gynecology, health economics, health policy, health system administration, labor support, maternal-fetal medicine, maternity nursing, nurse-midwifery, and quality and measurement research in health care.  The team comprised of individuals like Penny Simkin who are hoping to;  identify the optimal aims and attributes of the U.S. maternity care system, specify the most effective ways to realize those aims and attributes, and to move expeditiously to undertake the action steps.

On a personal level I just can’t stop reading about this project because I am so inspired by the mission and the individuals involved. I have included some information at the end of this article for further reading and I encourage you to do so. You may find it a bit overwhelming-its is a big undertaking and there has been quite a bit to report but if you are a pregnant woman, a birth junkie or a care-provider it is an essential read.  There are opportunities for us to get involved so let’s do all we can to implement this change-imagine being a part of this vision.  I just can’t get enough!

For more information and to find out how to get involved:

http://www.childbirthconnection.org/article.asp?ck=10627

http://www.childbirthconnection.org/pdfs/transforming-maternity-care-diagram.pdf

http://www.childbirthconnection.org/article.asp?ClickedLink=924&ck=10576&area=2

Birth Choices Expo’s aim is to make information about pregnancy, birth & parenting more accessible so that you can make the right choices for you & your baby and experience the joy of a positive more normal birth experience and a great start to parenting, just as you always dreamed. The last Birth Choices Expo at Annandale Community Centre in October 2009 was a great success, triggering a move to a larger venue to accommodate exhibitors and visitors for March 5, to mark International Women’s Day.

Good childbirth education has been proven to help women have more success with natural birth. Your natural birth begins long, long before you feel the first hints of labour. Birth Choices Expo at Leichhardt Town Hall on March 5th 2010 is the one stop place to start to gather this information. 6pm – 9pm FREE ENTRY!

Rising caesarean rates are proving to be a concern internationally; the World Health Organisation places the average acceptable rate at 14%, Australia is fast outpacing the USA, with caesarean Section rate of 40%. Pregnancy can be overwhelming physically and mentally with lots of decisions and choices to be made; Birth Choices Expo is a unique opportunity for women & families to meet a range of highly experienced birth professionals and obtain information on how to have a great birth, all in one evening in a supportive and fun community event.

PETER JACKSON, founder of Calmbirth® will be one of our two special guest speakers. As a male midwife working in a country hospital for over 20 years, Peter Jackson witnessed mothers whose experience of childbirth was one of fear, anxiety and trauma. He believed the answer lay in the preparation of the couple during pregnancy. Thus he developed the Calmbirth® Childbirth Preparation program. Peter is internationally recognised for his success in childbirth education. He offers over 30 years experience in General, Midwifery and Psychiatric disciplines of Nursing in Sydney and NSW regional hospitals.

RENEE ADAIR, founder of Australian Doula College. Renee first began working with women and babies in 1994 &1998 began studying and working as a doula, childbirth and early parenting educator and birth counsellor. For three and half years she then worked for the Australian Red Cross at their young women’s health program/refuge and set up both the outreach and childbirth and early parenting education programs for that service. Renee is the founder and principal educator of the Australian Doula College, The Centre for Spiritual Birth and Development and the registered charity Doula Heart Network. In her career she has supported hundreds of women, their partners and families through pregnancy, birth and the early parenting phase.

Come along on the 5th of March and you will have the opportunity, in a relaxed atmosphere, to meet with:
• Independent Midwives
• other parents, including dads at the Men at Birth table
• Birth Centre Midwives
• Doulas
• plus enjoy speakers, food, free show bags & more...
• Natural Health Practitioners
• Parenting Experts

FRIDAY 5 MARCH 2010, LEICHHARDT TOWN HALL. NSW 6 – 9 pm FREE ENTRY www.birthchoicesexpo.com.au

For Event information contact: helena@birthchoicesexpo.com.au / Mob: 0424 096 546
For further Press information or images or to arrange interviews, Contact: sacha@bluedakini.com.au /  Mob : 0418 264 755