Today, childbirth classes are conducted under a number of auspices hospitals, the American Red Cross, childbirth education groups, midwifery groups, doctors’ offices, community centers, college- and university­sponsored graduate education, churches, and visiting nurses services. A number of organizations train and certify childbirth educators, including ASPO, the International Childbirth Education Association (ICEA), and the American Academy of Husband-Coached Childbirth. National organizations such as these have set up specific outlines for classes and for training courses for childbirth educators. Many labor and delivery nurses and midwives also teach the child birth education classes without additional certification. Often, your midwife or physician will recommend a particular childbirth course or instructor.Remember that hospital classes will largely tell you about the specific policies of the hospital. Privately taught classes may provide you with more options, but not all of these may be possible if you are delivering at a hospital with set policies. You may want to talk with several childbirth educators before registering for classes to learn about their education, philosophy, and approach. You can check with the childbirth organizations listed in the Appendix to this book to learn whether a teacher has met any of their standards.

Classes in preparation for childbirth are generally started somewhere about the twenty-eighth week, although some educators offer early pregnancy classes. Early classes may focus on topics such as nutrition in pregnancy and common discomforts of pregnancy-things you have already experienced by the twenty-eighth week. Some teachers offer a brief series, or a single class, as a “refresher” for women and partners who took their classes for a previous birth. Special preparation classes are available for women planning to birth at home. You may wish to set up a schedule for your own needs with your childbirth educator.

There are also classes devoted to the care of the newborn. Indeed, hospitals often offer such teaching sessions to new mothers following delivery. These include the obvious features, such as diapering, feeding, and bathing a newborn baby; the basic pattern of newborn urination and bowel movements and the advantages and disadvantages of breast- and bottle-feeding. It may seem strange to the experienced, but women who are mothers for the first time sometimes are quite unsure of how to respond to a crying baby. They may be hesitant to follow their instincts, although these usually direct them toward bonding with the baby.

Exercise is another subject that may be stressed in classes in preparation for childbirth, not necessarily as part of a “method” but under the general heading of physical fitness. Little research has been done on exercise in pregnancy and exercise standards have not been developed for pregnant women. In general, if a woman is accustomed to strenuous exercise it will harm neither her nor her baby if she continues the activities during her pregnancy. If complications should develop, your physician or midwife may modify or restrict your exercise program. If you are used to being sedentary, begin exercise slowly in pregnancy and increase gradually.