Games and Activities for Childbirth Classes

 

I grant permission to use any of this information, and any of these class materials, in childbirth education classes. See details on my copyright policy here. All material is free of charge, but if you find it a valuable resource, I encourage you to donate what you consider a fair amount to the organization I teach for, Great Starts Birth and Family Education in Seattle. You may also want to consider taking our childbirth educator training, which I lead, or using my consulting services to improve your agency’s programs. – Janelle Durham

 

Icebreakers. A collection of ideas for icebreaker activities to help students get to know each other, and feel more comfortable in class.

Teaching Onset of Labor: some simple ways to teach the signs of labor.

Pop Quiz Review of Onset of Labor and Early Labor.  (edit-able word doc, pdf) Use at the beginning of a class, in small groups. One person reads the questions, group works together to come up with an answer, then flip over card to check answer. 10 minutes.

Labor “Cranium”: (printable Word doc, pdf) A game for reviewing and rehearsing labor. Mixes together: a pop quiz, discussion of labor scenarios, and labor rehearsal. (You could develop something even more like the board game Cranium by having a charades section and a drawing/Pictionary section where they act out and draw various items/topics associated with birth.) 30 – 60 minutes.

A Dice Game to Explore Normal Variations in the Length of Labor. The goal of this game is a simple little game that gets people interacting, and thinking about the random unpredictability of answering the question: “how long will my labor be?” 10 minutes. Or can be combined with variations presentation or with labor rehearsal.

Labor Scenarios for Practice (pdf)  Read scenario. Students identify where they think mom is in labor, then they propose three things that might be helpful to her (a position, a breathing technique, a comfort technique). They all then practice this. (I put up a Breathing and Comfort Poster (pdf) or the Road Map of Labor poster to give them hints about what options are available.)  10 minutes.

Labor Variations Scenarios for Discussions (pdf): Small group discussion. One student reads scenario. They discuss how they would feel and what they would do if this happened to them. Emphasize that there are no right or wrong answers.

Breastfeeding Thank-You Notes: PDF   Each card includes a cover picture of who’s saying thank you (e.g. your baby, your banker, your child’s teacher, your garbage man), a note on the inside summarizing the benefits to that person, and footnotes on the back with statistics, citations of journal articles, and other details. [Note: The file may print out in an unusual order, and you may need to rearrange pages before photocopying double-sided on card stock.] Can be used as a display, or can have students read out loud in class.

Breastfeeding Myths and Truths Game. PDF. Instructor passes out the cards, each student reads a card out loud, says whether they think it’s true, or whether they think it’s a myth. Instructor then gives more information about the topic. 10 minutes.

Love Languages in Labor PDF. A women’s magazine style quiz about learning what kinds of labor support are most likely to be helpful for a mom based on her “love language” (physical touch, encouraging words, gifts, acts of service, Presence)  Homework.

Where Will You Breastfeed PDF. Give one set to each mom. There are 9 cards asking “would you breastfeed *here*”. They sort them into yes, no, maybe piles. Then discuss as a group. Goal is to broaden their idea of where it might be OK to breastfeed. I got this idea from someone else… I think it was Teri Schilling or Ann Tumblin.

Teaching Healthy Choices: (word) interactive techniques for teaching nutrition, exercise, and substance avoidance.

Wellness in Pregnancy Postcards. PDF. Can be used as a display (see Lift the Flap below). Or as a game: you read the question out loud, the first person to volunteer an answer gets a candy or other prize. Good way to cover mandatory information on topics like smoking, alcohol, nutrition, and safer sex without having your students glaze over in boredom, or turn off from being “lectured” to.

Birth Plan Card Sort. PDF. There are many versions of this activity out there... This is mine. Each couple in class is given a deck of cards representing options (e.g. Labor Begins on its own / Labor induced on due date; No pain medication / epidural). They lay out their choices representing their birth plan, then you help them determine whether the plan is realistic (whether all the options they hope for are available to them and compatible) and help them explore how they would feel if they didn’t get some of what they wanted.

Media Moms or Media Images of Birth: At a birth class, ask “what images of birth have you seen in the media? What do you think our cultural attitudes toward birth are?” Discuss these, how realistic / unrealistic they are, and what impact these ingrained beliefs can have on our ability to birth. At a postpartum or newborn care class, ask “What are some mom/dad characters you’ve seen on TV or in pop culture?” As they list them, ask what characteristics these moms share, what kind of moms/dads they want to be, or don’t want to be. This exercise works well for helping students begin to develop their role identity as parents.

 

Lift the Flap games: these can be put on tables for people to look at before class begins, or over break. First, think up trivia questions. Write the answers on a 4x6 index card. Then cover the answer up with a 3x5 post-it note. Write the question on the post-it note. Students ask themselves the question, then check their own answers. Works great for nutrition, pop quiz review of labor, baby development trivia, etc.

Another great game is to find pictures of babies showing different cues: engagement, disengagement, tired cues, hunger cues, etc. Students guess what baby is trying to say, and flip it over to find the answer. There’s a great pre-made set of cards available here.

 

Ice Exercise to Explore Focal Points. Takes 10-12 minutes. Students hold bags of ice to simulate discomfort of a contraction. Do 6 contractions: no distraction, slow breathing, visual focal point, music, touch, movement. Full description of exercise.

 

 Onset of Labor game. I have prepared a dozen Post-It notes (the index card sized ones.) Each has on it a symptom such as “Cramps” or “Pinkish Discharge from Vagina” or “Gush of Fluid from Vagina.”  During class, I draw a continuum on the board, labeling the left side: “who knows”, the center “probably” and the right side “definitely.” I introduce the idea of the preliminary, possible, and positive signs of labor, as described in Pregnancy, Childbirth, and the Newborn. I hand out the post-it notes, and each couple reads a symptom out loud, then comes to the front of the room and sticks the post-it note on to the continuum, guessing whether it’s a definite sign of labor, or one of the more debatable signs. I then talk more about each symptom, frequently illustrating with examples of what my doula clients have experienced at the beginning of their labors. [Variation: I put all the post-it notes in the front of the classroom, and have all the dads/partners come up as a group. They work as a team to read all the items and figure out where to put them. This is great for helping the partners realize they need to know this information, and having the expectant mothers realize that their partners may already know more than they gave them credit for!]  15 minutes.

 

Brainstorming Comfort Techniques for Early Labor: Before class, I put up big sheets of paper around the room, labeled 1) Relaxing. List activities or environmental influences that help you feel mellow and safe. 2) Getting moving. List things that motivate you to get up and get active. 3) Distractions. List things that you do for fun, especially things which help you forget about your worries. 4) Fun with baby: List things you look forward to about parenting.

When students have arrived, I divide them up into small groups, and tell them we’re doing an icebreaker to get to know each other better. I send each group off to one of the lists to start brainstorming. I usually rotate them to a second list after a few minutes. Then, I have them hang the posters up in the front of the room, and we begin class, talking about early labor. When it comes time to address comfort techniques for early labor, I point out that the important things (beyond eating, drinking, and sleeping) are to alternate: rest, relaxation, distraction from worries, and preparing to welcome baby. I emphasize that there’s no special magical techniques, and that they already know everything they need to know for early labor. I point to each of the posters, and briefly go over how each of their brainstormed ideas would be helpful during early labor. 10 minutes.

I have also done this with other categories. For example, if I’ve just introduced Fear/Tension/Pain triangle, the three sheets say “Confidence Builders to Reduce Fear/Relaxation Inducers to Reduce Tension/Physical Comforts that Reduce Pain”.

 

Epidural Role-Play. Rather than lecturing on epidural procedures and side effects, I do it as a role-play with props. I introduce the basic info about what an epidural is, and what the benefits are. Then I ask for a dad to volunteer to be my model (it’s funnier that way, plus it doesn’t imply that any of the moms are more or less likely to choose epidural). I walk through the whole process, and all the paraphernalia, and what side effects they are monitoring for and trying to prevent. (I use some real items, like the oxygen mask, but my “monitor” is just a couple of elastic straps from the fabric store, and my “IV bottle” is a water bottle with a ribbon attached)

The key to making this as powerful as possible is knowing your statistics. For example, “the monitor is also monitoring your contractions. Dilation tends to move more slowly after epidural (9 out of 10 research studies have shown that labor will be longer overall with epidural than without). If contractions slow down too much, then you’ll be given Pitocin to get them moving again. (Pitocin is up to 2.8 times more likely with epidural than without.)”  I have a flip chart with the side effects statistics listed on it that I put up nearby while we  do the role play so I can refer to it from time to time, and students see the information as well as hear it. 

Also, when we’re all done, I put up a flip chart of: how to minimize your risks with epidural.  20 minutes. Here’s my lesson plan about the content I cover in this presentation.

 

Combined Epidural and Informed Consent Role Play. When I have enough time, this works very well for illustrating how to advocate for yourself and your partner. I roleplay a nurse coming in to do procedures, but don’t give them any information about why I am doing them unless they ask for information. For example:

Nurse: “OK, I’m going to put this blood pressure cuff on, and it will check your blood pressure every 15 minutes for the rest of labor.” If they don’t ask anymore, I leave it at that. If they ask “why do you need to monitor my blood pressure so often?” Nurse: “Well, there’s a good chance your blood pressure will drop after you’ve had the epidural.” Again, if they ask nothing, I move on (or hint that they might want to ask more if they’re not asking on their own). Students: “Why is it a problem for my blood pressure to drop?” Nurse: “well, that may cause baby’s heart rate to drop.” Students: “And what could that lead to?” Nurse: “Well, we may give you oxygen or medication to bring your blood pressure back up, and see if baby’s heart rate improves.” Students: “And what if the heart rate doesn’t improve? “ Nurse: “well, sometimes we have to do a cesarean birth, if we aren’t sure that baby is doing OK.” The key to making this work well is to have really talked before this about informed consent, and advocacy, and how to ask questions until you feel fully informed. Also, at the end of this, I put up a poster with all the information on it that I wanted to make sure they got, that way if we missed anything in the process of the role play, we can go over it at the end. 45 minutes.

 

Labor Rehearsal Options. 20 – 60 minutes.

1. Labor Stations. (Publisher document) (PDF) I tape these posters up around the room, then explain to the full class what each station is, what they should do there, and what benefits that activity would give during labor. Then, we spend about a half hour rotating through the stations: one couple is at each station. They have one minute to read the poster and get ready, then we do the comfort technique for a “one minute contraction” then rotate on to the next station. The nice thing about this exercise is it allows them to practice lots of ideas in a short amount of time. Be certain to emphasize that in labor, you would never switch what you were doing with every single contraction, instead, you would find something that worked, and stick with it for as long as it was working. (If I have enough time, I have them read the poster for one minute, practice for one minute, then spend one minute discussing with their partner what worked about that technique, and what didn’t work for them.)

2. Instructor Guided Walk-Through.   (Publisher document) (PDF)  I have the class gather in a circle around me, with their pillows, and one chair per couple. I then walk them through, for each stage of labor: 1) a verbal review of what that stage of labor looks like and what mom might need from her support person. Then, we go through each of the posters, where I hold it up to show them what position to do and tell them what technique to do. Then, we do a one-minute contraction with that technique, then move on to the next.

3. Video Review and Practice. I show a video of a woman in early labor with her support person. Then I talk with the class, verbally reviewing early labor and what they should be doing at this stage, and I make notes on the board. Then we practice some of the positions and comfort techniques they suggest. Then we do active labor, then transition, then pushing, each with video, discussion, and practice. Goal: seeing laboring women on the video helps to make the roleplayed practice contractions a little more real, as they have more of a sense of what they’ll be feeling like at that point in labor.

4. Students’ Choice Rehearsal. Once when I observed a class series by a new instructor, Tawnya Ostrer, the way she did her rehearsal on the final night was to basically say “I’m going to put on music. Every couple minutes I’m going to announce that a contraction’s beginning, and I’ll tell you when it’s passed. Go ahead and move around the room, and try different positions, try different comfort techniques to cope with each contraction. I’ll come around and give you feedback.” When she did this, I thought it would fail, and thought that students need more guidance than that. But… the students handled it marvelously, and it was a great rehearsal! They had to really think about what they know about breathing techniques, positions, etc. and come up with things to practice. I am certain that those students will retain the information better since they had to come up with the ideas rather than the instructor handing them the ideas. If you do this style of rehearsal, you could put up some posters with ideas for positions and breathing techniques in case they draw a blank. Here’s some sample posters. PDF

  

Videos: There are several videos we use in our classes, and other videos which I have previewed for varying reasons. I always take notes about content when I preview a video, so I have put these up on the website, in case you would like to know details on what any of these videos cover. Note, these are my informal notes on content… not always complete, not always grammatically correct, always my personal opinions about them. Videos include:

Aimee’s birth (single mom, unmedicated birth, 8 minute video, Injoy, 1996)

Breastfeeding Intensive (relatively inexpensive - $57, from Mother of 7, c. 2006)

Cesarean Births (Injoy, 27 minutes, 3 women share their stories of unexpected cesareans, 1995.)

First Years Last Forever (covers brain development, bonding with baby, discipline and self-esteem)

Jessica’s birth (Injoy, 10 minutes, 2001. Hispanic mom, epidural, AROM, Pitocin)

Kim’s Birth (Injoy, 1998, 11 minutes. Natural birth, lots of breathing techniques)

Miracle of Birth 2 (Injoy, 2002, 5 birth stories – we use this collection, rather than using Aimee, Kim, Jessica, etc.)

Newborn Care: A Guide to the First Six Weeks (Injoy, 2006)

Works of Wonder (Vida, 2000, 4 birth stories, plus Stages of Labor, and interventions content. Great collection)

 

There’s lots of other good stuff in the homework and handouts section that could be adapted for use in class.

All games by Janelle Durham, inspired by various sources.

 

Outlines for Childbirth Education Classes

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