Since late 2006, I have written at the top of each of my teaching outlines: “Talk less, listen more.” This simple reminder has  fundamental importance and has completely revolutionized how I structure and guide my childbirth classes. During each series that I teach, I realize how listening to the women and giving them a space in which to share, is one of the most important things I can offer. Though I studied principles of adult learning and designing effective curricula during my certification program, I started out my childbirth education journey with a lecture and information-heavy approach I’ve since heard called, “opening their heads and dumping information in.” As I continue to teach, I’m continually discovering ways to talk less, but hopefully, impart more, creating a guiding philosophy of “talk less, [they] learn more” for myself as I plan and implement my classes.

Real birth preparation

After my first year of teaching, I realized that couples that sign up for my classes are not really looking for pregnancy and prenatal care information, but for real birth preparation. They are there because the women want to learn, “Can I do this?” and “How will I do this?” and the men are asking, “How I can help her do this?” It feels almost insulting to meet this quest for inner knowing with a discussion about the benefits of prenatal vitamins. I had to confront the fact that some of the things I was teaching seemed irrelevant, redundant, or obvious.

It became clear to me that I had to tackle the slightly embarrassing reality that I was following a model of prenatal education that was not in line with the true needs of the women in my community. I teach independent, natural childbirth classes privately in people’s homes. Maybe with a different population, my original approach would be more successful or I would take a different approach altogether. Also, just as students have different learning styles educators naturally have preferred methods. I have an information-heavy personal style that spilled into my teaching. I continue to wrestle with this tendency and struggle to rein in the information overload approach I gravitate towards.

Action!

As I made my discoveries, I began to drastically cut my talk time (lecture) and focus on action instead. Though it felt nearly sacrilegious to do so, I trimmed many things out of my outlines that were about nutrition, prenatal testing and so forth, because many of the women I work with have already read a great deal and don’t need to hear it again from me. I’ve come to see I really need to skip a great deal of the “book learning” and get them actually moving and practicing and using skills. Then, the “book learning” naturally arises during the course of the class, either via questions or via me needing to explain why something is useful or helpful during pregnancy or in labor.

I totally restructured and rearranged my class outlines to include a whole class about the mind-body connection and psychological preparation for birth. This class took the place of a previous class about birth planning. I was finding that many people already had a birth plan written and/or the birth plan information naturally comes up during the course of the six weeks without my needing to spend an excessive amount of lecture time on it. I tell them that I have the information, ask if you want it! I also dedicated a whole class to labor support with plenty of time to practice hands-on support techniques. In addition, I created a brand new class called “Active Birth” that involves lots of moving and positioning as well as many helpful ways to use a hospital bed without lying down. Informed consent, consumerism, and birth planning naturally arise as topics during this class, rather than being separately scheduled topics.

Information overload

Many pregnant women have information overload. They are faced with more information than they know what to do with. They are bombarded by it. What they really need is “knowing.” They need to know: “What skills do I possess or can learn that will help me greet my birth with anticipation and confidence? What are my tools? My resources? Can I just let it happen?” As an educator I ask myself, “What will help them feel confident? Feel ready? Trust their bodies and their capacities?”

I want people in my classes to learn material that is dynamic, active, exploratory, self-illuminating, supportive, positive, enriching, and affirming. I created a vision statement and asked myself where my classes stood in relationship to my vision. The answer was, “not as close as I want them to!” My vision statement for my classes is: to focus on celebration, exploration, motivation, education, inspiration, validation, initiation, and dedication.

I know I’m hitting the mark when couples comment, “Oh, this makes so much sense! I see how this works!” Or, “This was a really good illustration of what you were just talking about.” In this way, class participants readily reinforce (or modify) my own presentation style and I learn from series to series what to change, continue using, discard, or alter.

“Talk less…” teaching tips

I have many ideas of ways to “talk less” in birth classes, here are a few:

• Media portrayals of birth—show two contrasting clips, such as a birth from a popular TV show (I often show Rachel’s birth from the show Friends) paired with an empowering birth from a film like Birth as We Know It and then have students discuss the two.
• Use “The Ice Cube Minute” exercise from Family-Centered Education: The Process of Teaching Birth. In this exercise, couples hold an ice-cube in one hand for one minute and see what coping measures spontaneously arise for them. I do this exercise fairly early in my class series, before we’ve done a lot of formal talking about coping measures. It is very empowering for couples to discover what tools and resources come from within as they try the ice-cube minute.
• To illustrate the potency of the mind-body contraction, practice two pretend contractions while holding ice. One contraction has an accompanying “stressful” paragraph read with it (“your body fills with tension…it hurts! Oh no!”) and the second contraction has a soothing paragraph read with it (“you greet the wave….it is YOUR power….”). This illustrates the fear-tension-pain cycle viscerally.
• Use a five minutes series of birthing room yoga poses to begin the class—birth happens in our bodies, not our heads. Practicing the poses opens space to simultaneously discuss and practice: squatting, pelvic rocks, optimal fetal positioning ideas, healthy sitting, pelvic floor exercises, leg cramp prevention, back pain alleviation, and more.
• Role playing cards—talk through various scenarios. I’ve found that couples are more receptive to talking through the cards than actually getting into a role and playing it through.
• Values clarification exercise–participants cut out values from a list and arrange them in a grid to help them figure out if they are in alignment with each other and with their caregivers.
• Leg stretch exercise to explore the use of vocalizations and other coping mechanisms during labor.
• Ask plenty of open-ended questions that stimulate discussion and ideas, “what have you heard about XYZ?” or “what is your experience with…?”

Evolutionary spiral of a childbirth educator

After I had already done all of this self-inquiry and curriculum modification, I discovered Trish Booth’s concept of “The Evolutionary Spiral of a Childbirth Educator.” I quickly recognized myself and my experiences along the loops of the spiral. In the Early Stage of the spiral, educators are focused on “content and presenting the information.” This perfectly matches where I was when I started out with my “open heads and dump information in” approach. The Intermediate Stage is focused on the “group as a whole” and also “emphasizes learning rather than teaching.” Though I tend to teach one-to-one private classes and not groups, this seems to clearly be the stage I was in when I looked at my vision and realized that I needed to talk less so people would learn more. In the Advanced Stage, the educator “understands the meaning of the childbearing experience” and the focus is on the “individual learners.” This feels like the stage to which my teaching has spiraled. Further along the spiral is the Master Stage in which the educator “integrates the first three stages and moves gracefully between them” with a focus on “cognitive, emotional, and spiritual needs of the group as well as the individual learners” (Booth, 1995).

Perhaps my insights are old news to experienced educators, but they have made a profound difference in the quality of my classes. I’m sure as I continue to teach, I will continue to deepen and refine my approach and will continue to blossom as an effective educator.

Molly Remer, MSW, ICCE, CCCE is a certified birth educator, writer, and activist who lives with her husband and children in central Missouri. She is the editor of the Friends of Missouri Midwives newsletter, a breastfeeding counselor, a professor of human services, and doctoral student in women’s spirituality. She blogs about birth, motherhood, and women’s issues at https://talkbirth.me/posts.

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Modified from an article originally published in the International Journal of Childbirth Education, December 2008.

References:

Booth, Trish. Family-Centered Education: The Process of Teaching Birth, ICEA, 1995.