Frequently Asked Questions about Childbirth Classes


I hope this answers the majority of your questions, but you are always welcome to ask more by contacting me at flhenry@mybirth.net because when you are pregnant or a new parent you can never ask too many questions!

 

I like to start this section with my favorite articles from FitPregnancy about childbirth options.

 

What Labor Nurses want you to know

 

The February/March 2011 issue of FitPregnancy had a sidebar called 'What Labor Nurses want you to know' which stated: Labor and Delivery nurses spend far more time with women in the hospital than OBs do, and they've seen it all. So what would they like their patients to know and do? The three points that a Perinatal Advisory Council survey of nurses in Southern California found most nurses agreed upon, along with some of their reasons and caveats:

1. Childbirth classes are a good thing. Knowledge and preparation decrease fear and pain. TV shows do not realistically depict what childbirth is like.

2. You should prepare a birth plan. Creating a birth plan may help mothers, especially first-timers, be more informed about their options. You should be aware of the need to be flexible and not expect everything to go exactly as planned. Using an Internet birth plan isn't ideal, as it doesn't help you become more knowledgeable about the process.

3. The right doula is welcomed. Continuous labor support from a confident and knowledgeable doula makes a huge difference in outcomes, especially if you want an unmedicated delivery. Choose carefully, some doulas are very helpful, but some interfere with nursing care.

 

10 Questions to Ask a Childbirth Educator

 

The June/July 2009 issue of FitPregnancy has a list of the 10 questions to ask a childbirth educator to help you pick a teacher (www.fitpregnancy.com). I decided to answer them to help you in your search for a childbirth educator.

  1. What is your certification? (Ideally, the instructor is certified by Lamaze, Bradley, the International Childbirth Education Association or another national group.) I am certified by the American Academy of Husband-Coached Childbirth, AAHCC or the Bradley Method.
  2. How long have you been teaching these courses? I have been teaching Bradley since 1992 (as a provisional teacher) and have been certified since 1993.
  3. What do you cover in your class? I cover the stages of labor, coping techniques (natural and medical), breastfeeding and baby care (no need for a separate class). Also pregnancy comfort tips, birth plans, ceseareans and anything else students want to know about. I welcome questions during class - it doesn't matter what the scheduled topic is, ask whatever is on your mind. [For a complete list check the Class Topics page.]
  4. What is your basic philosophy about childbirth? That our bodies are designed to carry and birth our children and all women are capable of birthing without drugs. That said, we live in a technocratic culture so women need to know what to expect from modern hospital birth and pain relief options. No woman should be bullied into having medication or a natural birth, I will give you the tools to make your needs known, no matter how often they change during labor.
  5. How do you feel about medication and induction? If feel they are overused - so women need to learn about them so they can make the best choice for their situation. I want my students to feel that they had a hand in making the decisions, not that they were 'a good girl' and did as they were told.
  6. How would you deal with a hospital's protocols if they don't match your own approach? If you can, make peace with what the hospital and OB/midwife will require and pick your battles or you can find another place to birth. In other words, the hospital won't change to meet your desires - you must change to meet them or switch birth places and birth attendants.
  7. What are the outcomes of your students' births? (Perhaps you can talk to a few of the instructor's past clients.) It seems to be an equal mix of unmedicated and medicated. But more importantly almost all are happy with their birth experience. I've never had a request to speak to previous students but I'm sure it can be arranged - the Student Comments page has responses I've received and many clients send friends and relatives to my classes (I feel the best indicator of a good birth outcome). You can also sit in on a class before you sign up. Many couples like this option - or we can set up a time just to meet (and to see if the drive is something you want to do for 10 weeks). I also started a Facebook page and some of my former students 'like' my page (http://www.facebook.com/pages/Mybirth-Childbirth-Education-Lactation-Consulting/173431646075246).  I am also on Twitter, Instagram & Tumblr as MybirthCBELC and on Goggle+ & Pinterest as Mybirth CBE & LC to find out a bit more about me.
  8. How many couples are in your class? (You'll get more personal attention in a small class.) It ranges from 2 - 4 couples, occassionally it will be only 1 and rarely as many as five. I like this size, everyone has a chance to ask questions, in fact no questions make a class dull and boring (I end up talking too much). It also makes it easier to make friends and exchange contact information between students.
  9. What is the time commitment? The class is 2 hours a week (from 7 to 9 pm) for 10 weeks - 20 hours. A class with one couple can be shorter, if needed - weekend classes are two 9-hour days (with a 1 hour break for lunch), mini-courses vary from 4 - 12 hours over 1 to 2 days, and a private class is as many days/hours you schedule. I can work out a time commitment/schedule to fit your needs.  We could also arrange a 'hangout' for a video class on Google+.
  10. Are you a lactation consultant? (This is a bonus if you're planning to breastfeed.) Yes, I am an International Board Certified Lactation Consultant (IBCLC, RLC) and I include 1 visit in my full Bradley class fee. Plus I have been a La Leche League Leader for the same amount of time I have been teaching and I have extensive lactation experience helping moms with newborns to toddlers.

 

Doesn't insurance pay for lactation consults, breastfeeding education & breast pumps?

 

Yes they do, a large part of the Affordable Care Act is that lactation consulting, breast pumps and breastfeeding aids are covered with no out of pocket fees. The reality is the no 'out of pocket' applies only to providers that are 'in-network'.  I am now a preferred provider for Aetna insurance so I can bill insurance for prenatal breastfeeding education (either part of my Bradley class fee, all of the Mini Course class 3 & 4 fee, or a private breastfeeding class if you had issues with a previous baby), lactation consults and any breastfeeding aid used during a consult.  For those who are covered under other insurance companies I have receipts that you can use for reimbursement for consults, classes, and breast pumps.  The best way to get insurance to pay for the breast pump that you want and will work best for you is to follow the links from Medela www.medelabreastfeedingus.com/tips-and-solutions/166/what-does-my-insurance-company-cover  for more information.

 

How to receive health insurance reimbursement/coverage for lactation consults:  Getting insurance coverage for lacation consults will also take some work. It would be best to call before you give birth so when you need lactation support you can get it quickly. Not too many insurance companies have IBCLCs (International Board Certified Lactation Consultants) in network, so if there is no lactation provider in network for your insurance, the following information can help you get reimbursed. Here are the steps of what to ask your insurer:

 

  1. Are lactation consults covered - if so, how many? Do I need pre-authorization or a prescription? If not covered, can I use FSA/HSA? What about breastfeeding aids?
  2. Who do I see, who is 'in-network?  Are there limitations on who I can see?  Is there a maximum dollar amount covered by a visit?
  3. If no one is 'in-network', can I see someone out of network?  What if I prefer someone out of network - can I pay the difference out of pocket or be reimbursed?  (Give them my name.) How will I be reimbursed - for visits & aids? (Direct from insurer or FSA/HSA?)
  4. Are these codes covered: CPT 99404, 99214, 99245, S9443, 99412 & diagnosis: 783.3, 676.34, 676.84, V24.1", if not, do they know which ones are?

Questions you may need to ask when you're pregnant about breastpumps:  Insurance companies vary in the type & brand of pump they offer, if you have your heart set on a specific pump here is what you should find out from your insurance company.

  1. Can I rent or buy my breast pump?  Is there a maximum amount you will cover?  Do I have to get a specific type (manual vs electric) or brand of pump?
  2. Do I need a prescription to get the breast pump?  Do you cover additional breastfeeding supplies (nursing pads, lanolin, SNS, nipple shields, etc)?  If so, do I need a prescription?  who should it be from - pediatrician, OB/GYN, or IBCLC?  If I need a prescription what should it say and does it need specific codes?  What about breast pump accessories?  (i.e., car charger, battery pack, milk storage bags, larger pump flanges).
  3. Can I get the pump before the baby is born?  (Many IBCLC's recommend you wait until the birth in case you need a rental pump.)  Do I have to go through a specific provider to get the pump?
  4. I want a different pump (electric instead of manual, rental over single user, or one brand over another) can I upgrade & pay the difference out of pocket?  Could I use my Health Spending Account or Flexible Spending Account for the co-pay or price difference?  Can I buy a pump (and/or breastfeeding supplies) from a store or IBCLC and be reimbursed?  If the provider you send me to is out of stock can I purchase the pump somewehre else and be reimbursed?  If not, what do you recommend if I need the pump before the provider you sent me to can get them back in stock?

When you make these calls to your insurance company you should document all conversations making sure you get the name of the person you are talking to, the date & time of the conversation, and the communication method (call, e-mail, etc).


What exactly does the ACA cover?


According to the National Breastfeeding Center insurance should cover the following (your policy may vary):

 

  1. Prenatal/postpartum breastfeeding classes - One class series in the prenatal period & 1 class series up 12 months postpartum, up to a total of 18 class weeks, no referral or prior authorization required.
  2. Breastfeeding support groups - one monthly meeting up to a total of 12 meetings, no referral or prior authorization required. (Just FYI all La Leche League groups are free so it doesn't matter about your insurance coverage, but some IBCLCs charge for their support groups.)
  3. In-patient hospital LC visits - no referral or prior authorization required.
  4. Outpatient hospital, home, or provider office/clinic LC visits - 6 visits per birth (2 hrs each), no referral or prior authorization required, prior authorization required beyond 6 visits.
  5. Rental pumps - maximum $1,000 for rental & kit for up to 1 year, requires prescription specifying medical necessity & length of need as advised by lactation care provider, one per birth event.
  6. Purchase pumps - maximum $1,000 for pump & accessories (1 every 36 months or pregnancy), needs prescription & should list specific pump for individual's needs as advised by lactation care provider.
  7. Pump kits - new kit with every birth, maximum of $150 per kit, second kit covered with medical necessity, additional kit request per birth if within 36 months of pump purchase.
  8. Other equipment, supplemental lactation aid, nipple shields, breast shells - maximum benefit of $250 per year and requires coding of V24.1.
  9. Donor human milk - for identified at-risk infants through the first 12 months of life, maximum 12 month supply, requires prescription by licensed provider; renewable every 3 months.

 

I hope this helps, you can always ask me if you have any other questions. I am still learning a lot about insurance coverage and I find it very interesting and exciting learning how it all works.

 

What is the Bradley Method of Childbirth Known For?

 

Bradley is named after Dr. Robert Bradley, an OB who wondered why the births he saw on the farm with the animals was peaceful, but with the women in the hospital they seemed so harsh. He wanted to make birth better for mothers and babies. He began training mothers to have an unmedicated birth with their husband (or other important person) by their side and they loved it. He didn't want the method named after him so the name of American Academy of Husband-Coached Childbirth was developed when the training of teachers began. Bradley classes consist of 12 weeks of instruction and a Student Workbook for each enrolled family*. While some people may think that Bradley Childbirth education 'makes' expectant parents 'difficult' the reality is since Dr. Bradley felt strongly that an expectant mother could refuse pain relieving drugs if she wished (when all women were given pain medication as soon as they entered the hospital without being told) couples with strong desires are also attracted to this method. As I like to say "I wish I had that much influence that some nurses & doctors think we have," most people have strong opinions before the come to classes. While I go over all options I can't make someone not listen to their care provider, hopefully you will learn to talk to them to get your questions answered.

 

Is there anything special I should read?

 

My favorite 3 books for pregnant moms to read are Natural Childbirth the Bradley Way, Birthing From Within, and The Womanly Art of Breastfeeding. I feel these 3 will prepare you for your baby's birth and care. All of these books are in my library as are many others I have found of great help and a wide assortment of DVDs. The books and DVDs may be kept as long as needed, but I do ask you try to return them before the last class. Other books I also recommend: The Thinking Woman's Guide to a Better Birth, Fearless Pregnancy: Wisdom and Reassurance from a Doctor, a Midwife and a Mom, The Birth Book and Bestfeeding: Getting Breastfeeding Right for You. I also like many of the books written by William & Martha Sears and Penny Simkin's book The Birth Partner. I would love to hear what books you are reading and what you are finding helpful. If you prefer movies and have Netflix 'The Business of Being Born' is usually available on streaming view as is 'Pregnant in American: A Nation's Miscarriage'. You can also rent them along with 'Orgasmic Birth - The Best Kept Secret'. They are excellent to watch and have wonderful research behind them.

 

Does a Birth Plan really help?

 

Yes it does, if anything it helps pinpoint what is really important to you so you can communicate with your birth team. While birth is always very unpredictable - your plan will keep changing as labor progresses - having your feelings down before helps your birth team to work with you as your baby decides the course of your labor. We also discuss how they should be personal - some birth plans can have one sentence. This is where the benefits of my in-depth Bradley Method class & mini course shine, we will discuss each possible interventation and you will learn to be your own advocate and help your coach when you want to change your birth plan. Another important part of a birth plan is letting the Labor & Delivery nurses know a bit about you - this is your first time meeting them! While you will discuss your wishes for labor with your OB/Midwife you will be working with the nurse at the hospital for the majority of your labor and we will go over many ways to let them know your wishes as part of your birth team.

 

Can childbirth classes really make a difference?

 

Yes, while there are many TV shows, books and websites to teach you about birth it's not always accurate. Studies show that women who took a good class felt it made all the difference in labor and they had more success breastfeeding. While women may not trust that they can deliver without epidurals and other medical interventions, it is the very use of all this technology that make taking an in-depth class more important than ever, even the quick, mini course will enhance your child birth experience. There are some childbirth teachers (and I am one of them) who feel it's less important what you cover as long as expectant parents can discuss and process the information they have. One thing you don't want to experience is regret, which can happen when you go into childbirth blindly. In labor (or while being prepped for a scheduled cesearan) is not a great time to learn the ropes and make major decisions - you will feel more in control and less fearful if you have childbirth information before the birth rollercoaster starts. I really strive to help expectant parents get the information they need for birth and after - my classes include breastfeeding class, diapering & bathing and baby calming techniques.

 

How do I choose the right class for me?

 

While most expectant couples will ask when and where a class is held (will it fit in with their due date) many more questions should be asked and answered to find the right one for you. Such as, what is the instructor's philosophy, training and experience. Are they open to different ideas and needs of individual couples? What techniques are taught - are they only for unmedicated births, only medicated birth or both. Is the mother's support person taught techniques to use during labor. Find out the typical class size, smaller classes usually allow more discussion time. Finally, find out who the teacher works for, some childbirth teachers who teach for a hospital or OB/midwife practice may have limitations on what is discussed in class. I pride myself on being open to my student's needs and desires for their birth and parenting goals. You can also observe a class and/or come for a visit to talk to make sure we 'click' before you sign up - I want to make sure you are comfortable in class.

 

What's wrong with just watching a video or reading to prepare for the birth?

 

Having a baby is such a life changing event and involves complex emotions, so discussing this information is the best way to process everything. Many childbirth educators feel that this is the most important part of childbirth classes even if you just meet a couple of times, such as in my mini course and/or private class. It is by taking the information you learn, the stuff you know, with your fears and feelings to discuss them with someone knowledgeable that makes all the difference between a class that was a great benefit and one that was a waste of time. Another great benefit of classes is avoiding the bad information that is easily available either from the internet or someone who doesn't have the fact straight. Especially since the Internet comes unfiltered there can be a lot of misinformation - when you meet someone face to face you can tell their bias and know how they got their information.

 

What are the fees for classes and services?

 

The fee for the full Bradley course is $175 which includes the Student Workbook, loaner Information Binder and lactation support. The mini-course is $40 per class or if you sign up for all 4 at once $130 for all. Private and refresher classes are $20 per hour with a 4 hour minimum. Lactation consults are $120 for the Initial consult and $100 for follow up consults, for home visits outside of Ventura, Oxnard and Camarillo there is an extra fee of $20.  Most initial consults last between 60 - 90 minutes and follow up around 45 - 60 minutes.

 

How do I sign up for class or schedule a Lactation Consult visit?

 

You can call or text me at the number below or e-mail/iMessage me at the e-mail address below to start the process of joining one of the most comprehensive childbirth classes available. All lactation consult visits are scheduled to meet your baby's feeding schedule - including weekends. Breast pump and pre-natal consultations (for moms with previous breast surgery, baby thought to have a cleft lip or palate, or other issues with mom or baby) are also by appointment only I am available 365 days a year since babies don't read calendars (or clocks) and parents still need help. No matter what time of year I'm available for you. I accept cash, check, credit cards and Google Wallet for payment.

 

*I shortened my classes to 10 weeks, all the information we would normally go over in the first 4 weeks we will cover in the first 2.