Module 1: Foundations of Childbirth Education
IN THIS LESSON
Topics Covered:
Historical and Cultural Perspectives on Birth
Explore how childbirth has been viewed and supported across cultures and time periods, honoring traditional birth practices from around the globe.Current Global Birth Trends and Outcomes
Compare maternal and infant health outcomes internationally, examining how systems of care (e.g., midwifery-led, hospital-based, or community-supported) impact families.Informed Decision-Making Across Diverse Settings
Understand how access to evidence-based information, language, education, and systemic factors influence the ability of families to make empowered choices—whether in the U.S. or internationally.
Introduction
While pregnancy and birth happen everywhere, the way they’re experienced can look very different depending on where you are in the world. Some cultures rely on long-standing traditions and community support, while others turn to hospitals and technology. These differences are shaped by history, culture, and access to care. As a childbirth educator, understanding how birth is approached in different places helps you connect with families from all backgrounds. In this lesson, we’ll look at how birth is viewed across cultures, explore global health outcomes, and talk about how families make decisions based on the information and support available to them.
1. Historical and Cultural Perspectives on Birth
Definition & Explanation
Pregnancy and childbirth are universal human experiences, but how they are understood, supported, and celebrated varies widely across cultures, histories, and belief systems. To be an effective childbirth educator—especially in diverse or international communities—you must go beyond teaching what is medically typical in one country or culture. You must understand that birth is deeply shaped by tradition, environment, and societal values.
In many traditional societies, birth is seen as a communal or spiritual event. Elders, midwives, or community birth attendants may play central roles. For example:
In parts of West Africa, women may give birth in squatting positions, surrounded by female relatives and birth supporters.
In Japan, quiet, focused birthing without epidural medication is often encouraged, rooted in beliefs around endurance and inner strength.
In Mexico, the rebozo (a traditional woven scarf) is used by midwives to ease discomfort and guide fetal positioning.
In contrast, in many Western medicalized systems, birth has become more individual and clinical—often taking place in hospitals, with technological monitoring, and more structured protocols.
Understanding these differences doesn’t mean one approach is “better” than another—it means recognizing that families arrive at your class with cultural expectations, fears, and hopes shaped by more than just biology or medical advice.
As an educator, it’s essential to validate these perspectives, ask open-ended questions, and avoid assumptions about what families want or need in their birth experience.
Scenario & Tip
Scenario:
During a class discussion about labor positions, one expecting parent from an Indigenous background shares that her grandmother gave birth kneeling on the ground and that her family wants to honor this tradition. Another student comments, “Isn’t that outdated? Hospitals don’t allow that anymore.”
Response:
You gently intervene and say:
“Actually, many families have strong cultural or ancestral traditions around birth, including specific positions or rituals. Part of our role as educators is to explore a range of options and support each person’s values. Let’s talk about how these preferences can be communicated respectfully with care providers.”
Professional Tip: When presenting mainstream birth practices, always frame them as options, not defaults. Make space to ask, “What are the birth traditions in your culture or family?” You’ll learn more—and so will your students.
Evidence-Based Insight
A 2022 review published in Social Science & Medicine found that culturally inclusive perinatal education programs lead to increased class satisfaction, stronger client-provider communication, and better self-advocacy during labor (Lee & Ahmed, 2022). The study emphasized that when educators include discussions of traditional practices, students are more likely to engage and feel empowered in their birth planning.
The culture war between doctors and midwives, explained
2. Current Global Birth Trends and Outcomes
Definition & Explanation
While pregnancy and childbirth are universal, outcomes vary significantly around the world. These differences are often less about biology and more about access—to respectful care, skilled providers, prenatal support, and postpartum recovery services.
Maternal health indicators such as cesarean rates, mortality rates, and breastfeeding initiation rates differ based on:
Healthcare systems (universal vs. privatized care)
Birth setting norms (hospital, home, birthing center)
Provider types (midwives vs. OB-GYN-led care)
Cultural preferences and socioeconomic status
Examples:
The Netherlands has one of the highest rates of home birth in the developed world, supported by midwife-led care and community postpartum support.
In contrast, the U.S. has one of the highest maternal mortality rates among high-income nations, particularly affecting Black women and people of color due to systemic disparities.
In Sweden and Norway, government-funded postpartum home visits and lactation support help improve infant outcomes and parental well-being.
Understanding these global patterns helps educators:
Identify best practices from around the world
Recognize how systemic factors—not just personal choices—shape outcomes
Encourage respectful conversations around what’s possible or ideal for each family
Scenario & Tip
Scenario:
You’re teaching a class that includes a recently immigrated couple from Kenya. They share that they expected to receive home visits after giving birth, as they would have back home. Another student, born in the U.S., is surprised: “Wait, people do that?”
Response:
“That’s a great question. In many countries, postpartum home visits by nurses or midwives are a standard part of care. Here in the U.S., it’s less common unless arranged privately. Let’s take a moment to discuss how expectations and experiences differ globally and how families can ask for more support here if they need it.”
Professional Tip: Use international examples to challenge assumptions and broaden perspectives. Not all parents realize what options might exist in other care models—and they may be able to advocate for similar support locally.
Evidence-Based Insight
A 2023 Lancet Global Health report emphasized that improving maternal outcomes globally requires attention to continuity of care, midwife-led models, and community-based postpartum support. Countries that invested in family-centered care—not just medical interventions—saw the highest satisfaction and best long-term health outcomes (WHO, 2023).
Traditional Midwives in Bolivia Join Doctors for Safer Births
Childbirth Education in Mongolia Saves Lives
Outdated childbirth practices persist in Europe
3. Informed Decision-Making Across Diverse Settings
Definition & Explanation
“Informed choice” means families understand their options and have the freedom and support to choose what aligns with their values, needs, and health considerations. But informed decision-making doesn’t happen in a vacuum—it’s influenced by:
Health literacy
Language access
Trust in the healthcare system
Cultural beliefs
Provider communication style
In some places, parents are encouraged to question and explore options. In others, there may be pressure to defer to authority figures or comply with standard protocols.
As an educator, your job is not to tell people what to choose—but to equip them to ask questions, understand risks and benefits, and make decisions they feel confident about.
Helpful framework for families:
What are the benefits of this option?
What are the risks?
What alternatives exist?
What if we do nothing?
Does this align with our values?
Scenario & Tip
Scenario:
A participant says, “My doctor told me I’m not allowed to eat during labor. But my mom gave birth in Brazil and was given soup between contractions.” The parent seems confused and unsure what to do.
Response:
“Policies around food in labor vary from place to place—and even from hospital to hospital. Let’s go over the reasoning behind those guidelines and how you might bring this up with your provider. What matters most is understanding your options and speaking up if you have questions or preferences.”
Professional Tip: Teach decision-making frameworks and scripts families can use to advocate for themselves. For example: “Can you help me understand the reason for that policy?” or “Is there flexibility based on my preferences and condition?”
Evidence-Based Insight
A 2018 Cochrane review on informed consent in maternity care found that families who received clear, culturally appropriate information and were encouraged to ask questions had significantly higher satisfaction with their birth experience—regardless of outcome. Those who felt “talked at” or pressured were more likely to experience birth trauma or regret (Gamble et al., 2018).
Making Informed Decisions During Labor: The Importance Of Consent
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Birth is not one-size-fits-all: Cultural traditions, access to care, and belief systems all shape how people give birth. Honor that diversity rather than assuming one “right” way to do things.
Outcomes reflect systems, not just choices: Global differences in maternal and infant health often point to systemic issues—like lack of prenatal care or biased treatment—not just personal decisions. Understanding this builds compassion.
Access affects autonomy: Informed decision-making isn’t just about having options—it’s about having the power to choose. Consider how education, language, and provider attitudes can support or limit that power.
Honor tradition and progress together: Traditional practices and medical advancements both have value. Help families navigate both worlds in ways that align with their values and comfort.
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1. Historical and Cultural Perspectives on Birth
Davis-Floyd, R. E. (2003). Birth as an American Rite of Passage.
https://www.ucpress.edu/book/9780520229327/birth-as-an-american-rite-of-passageTraditional beliefs and practices in pregnancy and childbirth – NCBI
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7589852/
2. Current Global Birth Trends and Outcomes
World Health Organization (WHO) – Maternal and Newborn Health
https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/maternal-healthThe Lancet Global Health – Global maternal and newborn health outcomes
https://www.thelancet.com/series/maternal-health-2016
3. Informed Decision-Making Across Diverse Settings
Elwyn, G., et al. (2012). Shared Decision Making: A Model for Clinical Practice.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445676/Listening to Mothers III: Pregnancy and Birth – National Partnership for Women & Families
https://www.nationalpartnership.org/our-work/resources/health-care/maternity/listening-to-mothers-iii-pregnancy-and-birth.pdf