Have prenatal classes come of age in India? How can they help the busy, expectant Indian moms of today?
By Priya Mani
First published on www.womensweb.in
While childbirth is a cherished moment in a mother’s life, it can also be quite overwhelming. Prenatal or antenatal classes serve to help expectant mothers by teaching them about pregnancy, labour, delivery, postpartum recovery and baby care. The thrust of these classes is to equip a mother-to-be with the technical know-how, physical fitness and emotional competence to embrace the experience of childbirth in a confident and positive manner.
Origin of prenatal classes
Prenatal classes had a modest beginning in Lamaze – a coping technique popularized by Dr. Ferdinand Lamaze in the 1950s. Although they have been in vogue abroad for over half a century now, in India, the concept of childbirth education has trickled in only in the last decade but is catching on well in the metros.
What to expect in prenatal classes?
Rakhi Kapoor, Founder, Dwi Maternity Studios, a Chennai based childbirth education centre/wellness centre defines the role of prenatal classes, “While the medical support is provided by the obstetrician, the other parameters that attribute to a pregnant woman’s general health and vitals are provided by these classes. These include adequate changes in an expectant woman’s diet and lifestyle to accommodate the nutritional needs of the growing foetus, basic fitness parameters to counteract the various changes in an expectant woman’s body owing to pregnancy, the demands of labour and childbirth, and post-partum recovery as well as emotional and psychological support for the various fears and anxieties revolving around this whole phase in a woman’s life.”
Thus, prenatal classes should include four components:
Diet – A dietician/instructor analyses the nutritional requirements for every expectant mother based on her medical reports and fitness history, and recommends fitting changes to her diet. A similar diet plan or chart is also recommended for post-pregnancy.
Exercise – Prenatal exercises are taught by a certified physiotherapist or prenatal fitness expert. They are specifically designed to prepare the body for parturition. Fitness for the expectant mother includes a combination of breathing techniques, antenatal yoga or stretches, and exercises that strengthen core muscles (especially the back and pelvic floor), boost stamina and enhance energy levels.
Most mothers swear by the efficacy of patterned breathing in aiding relaxation, relieving stress, and coping through contractions and labour.
Dealing with Childbirth – The joys of having a baby notwithstanding, going through the rigours of childbirth is typically a cause of apprehension and dread. The fear of childbirth is the fear of the unknown.
Prenatal classes familiarize their students with the signs and stages of labour, childbirth terminology, the procedures involved in delivery – both normal and caesarean, pain management during labour including the right positioning and breathing, as well as the choices of pain-relief medication available.
Armed with this knowledge, a couple can make informed choices even as labour unfolds and tension mounts.
Deepa Sridhar* shares her experience, “No doubt, a piece-by-piece account of what happens on the labour table did have me uncomfortable, even a tad scared. But in retrospect, I was glad to have been prepared. I was a lot less stressed on the D-day as a result. No amount of reading could have actualized this experience for me.”
Counselling and Orientation – If pregnancy is an uphill journey, the baby’s arrival is nothing short of a rollercoaster ride. Thus, prenatal classes also offer guidance on breastfeeding/lactation, fundamentals of newborn care and basic parenting, all during pregnancy itself.
Some of them even conduct postnatal sessions, three-four months after the birth of the baby to complete the transition from pregnancy to parenthood.
As Priya Srinivas, Childbirth Educator and Nutritionist, Mom’s Lounge, a wellness centre for moms succinctly puts it, “It is important to appreciate the fact that if a mother has twenty questions while being pregnant, she’ll probably have a hundred more once the baby is born. Hence it is recommended to go in for postnatal sessions after delivery.”
How to use prenatal classes:
Prenatal classes are open, interactive, fun sessions where parents-to-be get to clarify a lot of questions associated with pregnancy and childbirth – a luxury of time not available at the gynaecologist’s. They are also a wonderful forum to ventilate anxieties, debunk myths, and bond with other expectant parents.
Veena Mehta* shares her experience, “I was in my third trimester when I enrolled in a prenatal class. It was a time when an aching back, lack of sleep, and listlessness were getting the better of me. I was constantly out of humour.
This changed when I met women at the classes, some of who were also combating gestational diabetics, arthritis or taking daily shots as a part of IVF treatment, apart from the usual pregnancy woes. They helped me put my pregnancy in perspective.”
Prenatal classes emphasize both partners attending the sessions together, rather than only the mother. This enables the husband to understand better what the wife goes through, be a supportive labour partner and become a more clued-in, hands-on parent.
Soumya Vasudev* shares her experience, “Prenatal classes define the husband’s role in the mother’s support system and equip them so that they can take well-informed decisions when the mother-to-be may not be physically in a position to do so. In my case, though breathing techniques were the last thing on my mind as I laboured through in the final stages, my husband stayed cool and led me through the steps, thanks to his training in the classes. An added advantage – the massaging skills he had learnt in the classes proved to be soothing during the various stages of labour.”
That said, the labour support person can also be a close relative, a mother or a mother-in-law, who is then encouraged to attend the prenatal classes with the mother-to-be.
Prenatal classes: more relevant in India today?
Unlike the West, where attending childbirth classes is a necessity (since the couple may have to fend for themselves), in India support is ‘taken for granted’. The pregnant mother either goes to her mother’s place for delivery, or secures help from the joint/extended family.
However, things have changed with the rise of nuclear families. Besides, a greater number of women today are multi-tasking, career women, who between juggling deadlines at work and responsibilities at home, find it difficult to take care of their health.
Priya Srinivas says, “Neglect often leads to problems with pregnancy like fatigue, back aches, absence of weight management and lack of exercise. Attending prenatal classes helps working women cope with the pregnancy better.”
Like all things nouveau, prenatal classes too encounter a fair share of scepticism.
Ratna Deshpande* who attended Lamaze classes herself, articulates her views, “I am split on the benefits of knowing. Some get completely squeamish seeing videos from the other end. All women need to care is what they feel within and what to do when you had to “push”. The West believes in knowing the “enemy” – that knowledge empowers. I agree to a large extent, but it also can un-nerve you. Women have been giving birth forever. A lot of itcomes naturally to you.”
In India, the reluctance to embrace childbirth education comes with long-held attitudes like an implicit faith in the generations-old wisdom that frowns upon any exertion undertaken by a woman while enceinte. Priya Srinivas validates this, “There are some positions in prenatal exercises which Indian women are still hesitant and not comfortable doing, like full squats, low impact aerobics, using weights during exercise ( 0.5- 1 Kg ) and using the exercise / birthing ball.”
There is also the predominant perception that childbirth is a women-only affair. Unlike the West, where the spouse is the default labour partner, Indian society is squeamish about the inclusion of the husband, a male, in the birth experience.
But things are definitely changing, even as men are becoming more proactive fathers. Thus, prenatal classes prove to be a great bonding experience for expectant couples.
Prenatal classes are relevant especially in the Indian setup, where one is assailed by myths, misinformation, and midwives’ tales; and the dos and don’ts of pregnancy dictated by conventionality rather than any scientific basis.
By empowering her with knowledge, endowing her with health, and dispelling her fears/anxieties about childbirth, prenatal classes can help to foster the overall well-being of a mother-to-be.
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