Culturally Appropriate Childbirth Education

I was excited to present a workshop recently at the Evidence Based Birth Conference in Lexington, Kentucky. Along with my colleague, Jenny Cochran (Director of Embrace Refugee Birth Support in Clarkston, GA), I described the Healthy Moms curriculum we designed for pregnant refugees and immigrants. To address racial and ethnic disparities in maternal health, it is critical that childbirth education be accessible to ALL pregnant people. Most childbirth education has been designed for educated, middle class parents with fairly high levels of health literacy. Classes are developed for (heterosexual) couples and assume that a (male) partner will be present to provide labor support. In many immigrant communities, a male partner is not traditionally included in childbirth classes and is not expected to be present during birth. Furthermore, many immigrants speak little or no English and do not understand the jargon used to describe labor and birth. Questioning a provider about obstetric tests/procedures/interventions may be considered inappropriate. Through our work with immigrants from Myanmar, Congo, Afghanistan, Syria, and Central African Republic, we developed a non-English focused curriculum that uses graphics, interactive demonstrations, story-telling, an image-based birth plan, and multi-modal teaching methods. I developed a kinesthetic method for measuring labor contractions: breathing beads (you can see a photo of these beads on my Services page). In some cultures counting events over time, such as measuring the frequency and length of labor contractions, is a foreign concept. Using these beads parents can use an active strategy for measuring a sixty-second contraction. Low risk moms can learn to labor at home until they are likely to be in active labor, rather than rushing to the hospital at the start of labor. We believe all of the methods we developed for this curriculum would be applicable with diverse populations of parents, including those with lower levels of health literacy. No parents should have to go through pregnancy and childbirth without culturally appropriate education that empowers them to get the best possible maternity care.

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