But what about those more significant tears? It is true that large tears do happen. Fortunately, research has shown us that there are ways to reduce the risk of tearing during a vaginal birth. Some of these ways of preventing tears can be done before childbirth, while others are done during birth.

Before childbirth

1. Perform perineal massage.

Perineal massage is a type of stretching for the vagina to prepare for childbirth. Typically, a pregnant person does the stretching on themselves by using one or two thumbs to widen the opening of the vagina, although sometimes a partner helps. Here’s a link to directions on how to perform perineal massage. 

Research done between 2022 and 2024 on perineal massage done prior to birth compared with birthers that did not do any prenatal perineal massage found that it:

• Reduced the risk of any tearing, but specifically reduced tearing that needed stitches by 9%
• Reduced the risk of needing an episiotomy (an incision to widen the vaginal opening) by 17%
• Reduced the risk of perineal tears that reached the anus (grade 3 and 4) by 64%.
• Reduced pain in and around the vagina after birth for 3 months after birth
• Reduced swelling in the perineal area in the first 10 days after birth
• Reduced the involuntary loss of gas in the 45 days after birth.

How much perineal stretching should you do? Perineal massage is often started eight to four weeks prior to the expected due date. It can be done daily for 5-10 minutes per day. It can be done sitting or lying down.

Pregnant people should check with their medical provider before starting perineal massage. Frequently, people on pelvic rest or at risk of early delivery may be instructed not to perform perineal stretching. 

2. Consider Kegels

Kegel exercises are also known as Pelvic Floor Muscle Training (PFMT). Some studies show decreased frequency of episiotomy, and less tears that reach the anus (grade 3 and 4) when Kegels are performed. However, a systematic review shows that after urinary incontinence develops in pregnancy Kegel exercises don’t improve incontinence before birth or in the year after birth. The same systematic review also looked at preventing urinary incontinence in pregnancy and results were a decrease in developing urinary incontinence of 62% with performing Kegels. Therefore, the recommendation is that Kegels be considered by women as a potential aid to prevent urinary incontinence.

How many Kegels should I do? One study prescribed 5 to 8 second Kegels, then 8 seconds of rest, repeated for 10 minutes, three times per day. However, the Mayo Clinic recommends sets of 10-15 Kegels three times per day. A systematic review found wide variation in dosing and determined that there were no recommendations for maximum benefit. When to start is also widely variable. Some recommend starting as early as 12 weeks gestation, while other studies looked at starting near term. 

3. Practice birthing positions ahead of time.

Certain positions are more likely to lead to larger perineal tears. These positions are ones where the sacrum (part of the low back) is pressed against another surface, such as a bed or chair. Research has shown that perineal trauma is reduced when giving birth on one’s side or kneeling out of a bed. Pushing in a squatting position has been shown to decrease overall time of pushing but has a slightly higher risk of tearing than the other two. Squatting with a grab bar or something for the birther to hold on to is more comfortable. Often, it is easier to remember what TO DO when it comes to birthing, versus what not to do. For this reason, I encourage birthing people to practice positions that will be less likely to cause tears (sacrum is freer to move). Here are some things to practice before going into labor:

• Side-lying
• Kneeling
• Squatting

Recent research suggests that upright positions in general are less likely to lead to tears while horizontal positions are more likely to lead to a birthing person having an episiotomy performed. Use of an epidural has not been found to increase the risk of severe perineal tearing.

4. Make a perineal tear prevention plan.

A study in 2026 compared individualized prevention plans with standard care. The results of the study showed that those with individualized plans had significantly lower rates of episiotomy, 15% shorter second stage labor, and significantly less pain in the postpartum period. So, make a visit to the midwife or obstetrician to talk about ways they can reduce the risk of perineal tearing during birth. It is much easier to include perineal tear prevention strategies in the birth process if they have been agreed upon before labor starts.

Here are some of the common ways a midwife or obstetrician might try to reduce the risk of perineal tearing:

• Controlled birth of the baby’s head
• Individualized positioning to optimize the pelvic outlet
• No routine episiotomy
• Warm compress on the perineum with pushing
• Continuous communication between the birther and the medical and nursing staff.

Warm compresses with pushing can be created from clean washcloths that are soaked in warm water, changing as they become cool. A systematic review showed that there were more of intact perineum, tears that didn’t need to be stitched, less overall tears, less rate of episiotomy, and less pain in the birthers who had warm compresses than in those that didn’t.

During childbirth

5. Consider fewer vaginal examinations during labor.

Having five or more vaginal examinations is associated with a higher risk of a severe perineal tear, even when other factors are controlled for. A birthing person might consider requesting the medical team to only perform medically necessary examinations, so that the exams are limited to as few as possible.

6. Get in the water for pushing.

Waterbirth has been associated with having no perineal tears at birth, at a rate which is significate when compared to those not in water. First time birthers were also significantly less likely to have an episiotomy. Being in water also decreases pain in labor and at the time of birth. If a birthing person is interested in a water birth, they should be sure to check (a) that they have a provider who will honor their wish to birth in the water and (b) that a tub will be available. A tub may need to be rented or purchased depending on the birthing location.

7. Push with an urge and breathe through pushes.

Some birthing people are instructed to push right when they reach 10 centimeters of dilation, while others wait until they feel the urge to push. Delaying pushing does lead to a slightly longer second stage of labor; however, the time of active pushing by the birther is shorter. To spontaneously push the birther should push without holding one’s breath. One technique is to inhale over a second or two, then exhale over 4-5 seconds. Benefits of delayed pushing are slightly more spontaneous vaginal births, and perhaps less fatigue as active pushing is less. Studies show mixed results as to whether delayed pushing prevents lacerations. If someone plans on doing delayed pushing without breath holding, it can be helpful to discuss this decision with the midwife or obstetrician ahead of time, so that the birthing person does not receive unwanted coaching.

Conclusion

Keep in mind that regardless of the amount or type of tearing, the human body has a tremendous capacity for healing. This includes the ability to heal from tears and episiotomies. If a perineal tear does occur, with or without preventative measures being taken, it is not the birthing person’s fault. There are many forms of support for recovering from a perineal tear, from medical treatments to support groups. Regardless of the outcome, birthing people have options for feeling restored. These days, there are many specialists from pelvic floor physical therapists to medical doctors who are board-certified in female pelvic medicine and reconstructive surgery (FPMRS), also known as a urogynecologist, as well as colorectal surgery. No one should suffer alone. If you have a student, client or patient with a significant tear who needs support, please share the resource Life after Fourth Degree Tears.

References

Ahmar, H., Sofyana, S., Suciati, S., Ernawati, & Liantanty, F. (2025). Labor position and its impact on the birth process: A literature review. Journal of Current Health Sciences, 5(2), 97-108. https://doi.org/10.47679/jchs.2025115

Burns, E., Feeley, C., Hall, P. J., & Vanderlaan, J. (2022). Systematic review and meta-analysis to examine intrapartum interventions, and maternal and neonatal outcomes following immersion in water during labour and waterbirth. BMJ Open, 12, e056517. https://doi.org/10.1136/bmjopen-2021-056517

Chen., Q., Qui, X., Fu, A., & Han, Y. (2022). Effect of prenatal perineal massage on postpartum perineal injury and postpartum complications: A meta-analysis. Computational and Mathematical Methods in Medicine, 2022, 3315638, 1-10. https://doi.org/10.1155/2022/3315638

Cohen, W. R. & Friedman, E. A. (2024). The second stage labor. American Journal of Obstetrics and Gynecology, 230, S865-S875. https://doi.org/10.1016/j.ajog.2022.06.014

da Costa Monguilhott, J. J., Bruggemann, O. M., Velho, M. B., Knobel, R., & Costa, R. (2022). Antenatal perineal massage for trauma prevention: A pilot randomized clinical trial. Acta Paulista de Enfermagem, 35, eAPE0381345. http://dx.doi.org/10.37689/acta-ape/2022AOO3813459

Delusa-Lopez, P., Cuenca-Martinez, F., Sanchez-Martinez, V., & Sempere-Rubio, N. (2024). Maternal outcomes using delayed pushing versus immediate pushing in the second stage of labour: An umbrella review. International Journal of Nursing Studies, 152, 104693.

Gluck, O., Herman, H. G., Tal, O., Grinstein, E., Bar, J., Kovo, M. et al. (2020). The association between the number of vaginal examinations during labor and perineal trauma: A retrospective cohort study. Archives of Gynecology and Obstetrics, 301(6), 1405-1410. https://doi.org/10.1007/s00404-020-05552-z

Halfdansdottir, B., Ellinger-Kaya, K., Fjosne, K., Lindgren, H., Hegaard, H., & Blix, E. (2024). The association between waterbirth and perineal injury or other adverse outcomes among low-risk women with physiological birth: Result from the Nordic Home Birth Cohort Study. Women and Birth, 37, 101625. https://doi.org/10.1016/j.wombi.2024.101625

He, R., Wang, X. X., Nian, S., Wang, X. Q., Zhang, L., & Lu, Y. (2023). The effect of pelvic floor muscle training and perineal massage in late pregnancy on postpartum pelvic floor function in nulliparas: A randomized controlled clinical trial. Complementary Therapies in Medicine, 77, 102982. https://doi.org/10.1016/j.ctim.2023.102982

Jissa Donel, & Anuchitra, S. (2025). Evidence based comparison of merits and demerits of different birthing positions and practices: Narrative review. International Journal of Developmental Research, 15(1), 67589-67593. https://doi.org/10.37118/ijdr.29196.01.2025

Kunkel, M. E., Picanco, C. P., Santos, M. V., Schor, P., & Zanetti, M. R. D. (2024). Preventative approaches to perineal trauma in vaginal delivery: Systematic literature review. Brazilian Journal of Motor Behavior, 18(1), 1-11. https://doi.org/10.20338/bjmb.v18i1.407

Mayo Clinic Staff (2024, October 8). Kegel exercises: A how-to guide for women. https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283

Nguyen, N. T., Lam, Q. M., & Do, H. T. (2024). The effectiveness of warm perineal compresses during the second stage of labor on perineal trauma and labor pain: A systematic review. Journal of Research Development in Nursing and Midwifery, 21(2), 16-21. https://doi.org/10.61186/jgbfnm.21.2.16 1

Okeahialam, N. A., Sultan, A. H., & Thakar, R. (2024). The prevention of perineal trauma during vaginal birth. American Journal of Obstetrics and Gynecology, 203. https://doi.org/10.1016/j.ajog.2022.06.021

Waller-Wise, R., Lewis, S., & Williams, B. (2020). A quality improvement project utilizing a clinical practice guideline in women during second-stage labor. The Journal of Perinatal Education, 29, 72-82. http://dx.doi.org/10.1891/J-PE-D-19-00014

Woodley, S. J., Lawrenson, P., Boyle, R., Cody, J., Morkved, S., Kernohan, A. et al. (2020). Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, 5, CD007471. https://doi.org/10.1002/14651858.cd007471.pub4

Zafarovna, B. Z. (2026). Individualized labor management strategy for the prevention of soft tissue birth canal trauma: A clinical and prognostic analysis. Medical Research Journal, 2(3), 1-8. https://mrjedu.com/index.php/mrjedu/article/view/330/225

Zhang, D., Bo, K., Montejo, R., Sanchez-Polan, M., Silva-Jose, C., Palacio, M. et al. (2024). Influence of pelvic floor muscle training alone or as apart of a general physical activity program during pregnancy on urinary incontinence, episiotomy and third- or fourth-degree perineal tear: Systemaic review and meta-analysis of randomized clinical trials. Acta Obstetricia et Gynecologica Scandinavica, 103, 1015-1027. https://doi.org/10.1111/aogs.14744

It has been over ten years since the American College of Obstetricians and Gynecologists (ACOG) changed the definition of the start of active labor from 4 cm to 6 cm of dilation (Caughey, 2014).  While most Educators updated their teaching curriculum to account for the change, some may still need to adapt the emotions and expectations of the previous definition of early labor.  The definition of active labor beginning at 6 cms requires different thinking about the phases of labor and how we teach parents to recognize and cope with each phase.  If we do not explore the changes from cm 4 to 6 with future parents, we are not adequately preparing them for the skills and techniques needed to avoid going in too soon.  

For most laboring parents, their experience of intense contraction pain and the need for comfort measures and emotional support starts well before 6 cm of dilation.

Katie Rohs CD(DONA), LCCE teaches a 4^th phase in early labor: "In addition to the traditional "early", "active", and "transition" phases of the first stage, I teach a 4th 'phase' of labor called 'Early Getting Into Active' which is approximately 3 or 4 to 6 cm. There are such clear emotional & physical changes that happen in this phase that I find it to be critical to teaching realistic expectations."

Janelle Durham LCCE reiterates the work needed from centimeters 4 to 6 : "The important message is that laboring parents have to do really hard work to get from 4 - 6 cm, and they shouldn't be discouraged if that phase is really challenging and it takes a while - that's normal. I think it's almost as if we're adding a fourth phase to 1st stage: early labor is the warmup - then there's the intense-but-slow-progress of "getting into active" - the intense-but-at-least-there's progress of active labor - and then transition."

Here are a few tips for teaching about the laboring woman’s needs from cm 4 to 6:

Use AV aids that realistically show what parents experience in each phase of labor.  One of the best teaching graphics may still be Penny Simkin's Road Map of Labor depicting parents' coping at all phases of labor. (Please note, the Road Map of Labor also appears on page 498 of the latest edition of Pregnancy, Childbirth and the Newborn, 2024.)

Teach parents that the ability to cope is independent of cervical dilation.  Ability to cope varies depending on numerous factors, including pain intensity, speed of labor progress, knowledge of comfort measures, understanding what is going on with the baby and cervix, having good support and patient caregivers and companions.

Teach realistic expectations about when to arrive at the birth location.  Most hospitals prefer admitting laboring parents at 4 cms dilation or beyond and parents need to understand reaching the active labor threshold for most first-time parents will take between 15 - 24 hours. The greatest areas of influence childbirth educators have is teaching parents to cope confidently with a long early labor, recognize the signs of labor progress, and understand the signs and signals of when to appropriately leave for the birth place. Many hospitals recommend that laboring parents arrive at the hospital when contractions are 3 minutes apart or if the bag of waters breaks. Additionally, hospitals may recommends discharge home if:

• Cervix 4-5 cm without change x 2 - 4 hours
• Less than 80% effacement
• Membranes intact
• Reactive NST/FHR category I (if uterine contractions present)
• Contractions less than 3 in 10 minutes

Tracy McPhillips PCD(DONA), LCCE: "The instructor is key to helping parents understand what it's like to progress from early labor into active and when it's time to leave for the birth place or call the midwives to come. Ideally, class members develop patience for how labor unfolds and appreciate the need to learn and use skills to cope with a longer early phase of labor.

Focus on teaching coping skills and comfort techniques to increase parents' ability to confidently cope with labor pain intensity, regardless of the phase of labor.  Instead of creating false expectations that the latent phase of labor will be the easiest phase of labor and last until 6 cm, childbirth educators must prepare parents to confidently cope with whatever intensity they feel whenever they feel it.

Penny Simkin – known as the  ‘Mother of the Doula Movement’ once said:

"If we don't prepare people to cope with early-to-active labor, we are not doing our job."  She further recommended that "We should go into detail about the emotional and physical challenges that come with getting into active labor, and tie them in with cervical changes and the 6 Ways to Progress, which we have already covered in class. (i.e. the contractions intensify before the cervix responds with dilation, as it continues thinning, moving forward, and ripening). The cervix tends to resist dilation until it becomes very thin. This causes an emotional struggle for the laboring person, who may feel overwhelmed and anxious, especially if they think the contractions are very intense and doing nothing”.

They struggle with "control," and may decide it's too hard and request an epidural, or they may release control ("I can't do this. It's too hard. My body will have to do it!"). (I've wondered if the well supported laboring person releases control about the same time that the cervix lets go -- just a thought!) When she does release control, she often becomes more instinctual and discovers her own spontaneous ritual.

From my experience, I've learned that when in this instinctual state, "coping" seems to consist of spontaneous behavior, which includes the "Three Rs:" 1) Relaxation between contractions (if not during contractions); 2) Rhythmic behavior (breathing, vocalizing, moving; or rhythmic mental activity, such as counting, a mantra, a song); and 3) Ritual, which is the repetition of these rhythmic behaviors for many contractions in a row. After that, labor becomes more manageable, not because the contractions are less intense, but because the laboring person has discovered how to work with the contractions. A key point is that in order to get through this challenge, the laboring person really benefits from freedom to move around to seek comfort, and "emotional safety," which I define as unconditional acceptance by others of the way they discover to cope -- sounds, movements, etc.

The laboring person shouldn't be criticized (even though the intention of the criticism to be helpful: "You're breathing too fast" "Try to stay still during your contractions or you'll exhaust yourself" "Those high-pitched sounds aren't doing any good. Try to lower your pitch." This translates to the laboring person as, "I'm doing it wrong. They disapprove." The laboring person is likely to remember, "I was awful in labor. I did it all wrong," rather than, "I found a way to cope!" We should teach that these 3 Rs (Relaxation, Rhythm, and Ritual) indicate that the laboring person is coping, and teach the partners to match the laboring person's rhythm in some way (head or hand movements; stroking the laboring person's arm or back, vocalizing with them, etc.)"

‘PAIN’ and The Other 3 R’s

In addition to Penny Simkin's 3 R's, Audrey Miles Cherney, Great Starts Program Manager and Childbirth Educator, talks about "labor P.A.I.N." and really emphasizes the need to relax during the contractions, releasing any muscles not needed to support oneself during a labor contraction, as well as the "other 3 R's" that are important during the "resting time" between contractions.

Audrey explains, "As many educators do, I teach families about the acronym for labor P.A.I.N. as a way to transform a word with which we otherwise have negative associations. "Pain" is a word that is often assumed as meaning "suffering" or that something is wrong that has to be put right and healed, but there are many ways to experience pain and the sensations of labor without suffering and to work with it, instead of fighting or resisting it. When I explain the acronym, I talk specifically about how labor is "Powerful" as well as "Purposeful". It is the laboring person's inner power and strength at work signaling what we need and when we need it when birthing the baby. In one such way, it is a signal to be in their "safe place" and to be surrounded by the people who make them feel safe, if not also loved and respected, and help them be comfortable during this process. Early on, their safe place may be in their neighborhood going for a stroll, then a little later at home actively coping with partner and/or doula. And then even later still, either at the hospital with their medical team, or at the birth center or at home with their midwife. And while we can "Anticipate" what will work for coping, such as with Penny Simkin's "3 R's", we can also anticipate that the strong sensations of labor are "Intermittent"--that there will be a peak with each powerful surge and then it subsides and allows time for the "other 3 R's" to happen: Rest, Rehydration/Refuel, and Reconnect as a couple (or Regroup as a team, and ask questions, or Re-strategize if something is not working).

These elements between contractions work in compliment to what is happening during contractions since the resting time is at least as important to the support happening during the contractions when it comes to maintaining one's ability to reasonably cope and achieve better outcomes overall. And, of course, barring any medical complications, the sensations of pure labor are "Normal." Our bodies are designed to give birth, just as it is designed to breathe and digest food. We certainly do not give birth every day, but it is still a normal physiological process we are designed to do. According to WHO estimates, every second there are 4-5 babies born, so literally, there are hundreds of people worldwide giving birth to babies any given minute. As has been noted by many others before, the human race would not have survived this long, or been so successful breeding if our ability to birth was inherently flawed."

Building parents' confidence in their ability to cope takes time. There is no way around it: Mastering self-comfort coping skills is reached through repetition and practice. Educators should aim for 35% - 50% of their class time teaching and practicing physical and emotional/mental coping skills for labor and self-advocacy skills for shared medical decision-making.

Conclusion

The new guidelines, "6 is the New 4" will lower cesarean rates for failure to progress, but they require laboring persons to be able to endure longer labors, and potentially more emotional distress if they have not found ways to cope. Even those with an epidural find the longer duration of labor until they are eligible to receive and epidural to be stressful. Labor is as much an emotional experience as a physical one for the laboring person and their team. Our job as childbirth educators is to present them with accurate information, help them develop realistic expectations and practice the skills they will need to cope successfully with this challenge.

References

Caughey, A. B., Cahill, A. G., Guise, J. M., Rouse, D. J., & American College of Obstetricians and Gynecologists. (2014). Safe prevention of the primary cesarean delivery. American journal of obstetrics and gynecology, 210(3), 179-193.

Simpkin P, Whalley J, Keppler A, Durham J & Bolding A. (2024). Pregnancy, Childbirth and the Newborn: The Complete Guide.

Wagner, C., Zabari, M., Handel, S., & Director, I. C. (2015). Best Practice Recommendations for Labor and Delivery Care.

Originally Published 06/14/2016
Revised 06/17/2027

In 2026, the Lamaze Six Healthy Birth Practices continue to be strongly supported by international research and clinical guidance. Many recommendations now considered standard were introduced years ago, yet they are not always consistently reflected across curricula or teaching materials.

This reflection offers a moment to pause and take stock. It brings together key evidence-aligned updates that reinforce the Six Healthy Birth Practices and support educators in keeping curricula current, credible, and responsive to the realities families face today.

Our goal is to ensure Lamaze Childbirth Education continues to reflect the clarity, confidence, and depth that current evidence offers.

Birth Practice 1 — Let Labor Begin on Its Own

International research and clinical guidance increasingly recognize that labor often unfolds more slowly than previously taught. Active labor is now widely understood to begin closer to 6 cm dilation rather than 4 cm. This reframing helps normalize longer early labor and reduces unnecessary concern when progress does not follow outdated timelines.

Guidance from multiple countries emphasizes patience with early labor when there are no clinical concerns and encourages thoughtful timing of admission based on the full clinical picture.

Teaching Reflection
This evidence supports deepening conversations about patience in early labor and helping families understand that longer early labor is a normal and healthy variation. Reinforcing how time and patience support physiologic birth strengthens alignment with this Birth Practice.

Sources

• World Health Organization – Intrapartum Care for a Positive Childbirth Experience
  https://www.who.int/publications/i/item/WHO-RHR-18.12
• National Institute for Health and Care Excellence (NICE) – Intrapartum Care Guidelines
  https://www.nice.org.uk/guidance/cg190
• American College of Obstetricians and Gynecologists (ACOG) – First and Second Stage Labor Management
  https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2024/01/first-and-second-stage-labor-management

Birth Practice 2 — Walk, Move Around, and Change Positions Throughout Labor

Freedom of movement during labor remains one of the most consistently supported practices in maternity care. Research continues to associate movement with improved comfort, coping, and overall satisfaction with the birth experience.

More recent evidence has helped clarify why movement is so supportive. As labor unfolds, movement allows the pelvis, soft tissues, and fetus to respond dynamically to contractions. Changing positions can support fetal rotation and descent, reduce discomfort from sustained pressure, and help regulate sensation and fatigue.

The emphasis remains on movement itself: changing positions, adjusting posture, and avoiding prolonged immobility. For individuals using epidural analgesia, supported position changes continue to offer benefits related to comfort and pressure relief, guided by safety and individual needs.

Teaching reflection
This evidence reinforces movement as a foundational labor support practice. Teaching can focus on responsiveness to sensation, fatigue, and comfort; normalizing frequent position changes; and affirming that movement supports physiologic labor.

Sources

• World Health Organization – Intrapartum Care for a Positive Childbirth Experience
  https://www.who.int/publications/i/item/WHO-RHR-18.12
• Cochrane Database of Systematic Reviews – Maternal position and mobility in labor
  https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003934.pub4/full
• American College of Obstetricians and Gynecologists – First and Second Stage Labor Management
  https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2024/01/first-and-second-stage-labor-management

Birth Practice 3 — Bring a Loved One, Friend, or Doula for Continuous Support

Few practices in maternity care have as strong and consistent an evidence base as continuous labor support. Across diverse settings, continuous support is associated with improved birth outcomes and more positive birth experiences.

This practice remains central to Lamaze philosophy. Support may come from partners, chosen family, doulas, or a combination that reflects each family’s needs and circumstances.

Teaching reflection
Teaching can reinforce the value of continuous presence and help families think intentionally about who will provide support, how roles may shift during labor, and what support looks like for them.

Sources

• Cochrane Database of Systematic Reviews – Continuous support for women during childbirth
  https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003766.pub6/full
• World Health Organization – Intrapartum Care for a Positive Childbirth Experience
  https://www.who.int/publications/i/item/WHO-RHR-18.12

Birth Practice 4 — Avoid Unnecessary Interventions

The Healthy Birth Practice, Avoid Unnecessary Interventions, reflects evidence showing that interventions are most beneficial when used thoughtfully and for clear clinical reasons. Guidance across maternity care systems supports distinguishing between interventions that are medically indicated and those that may be applied routinely without clear benefit.

Current evidence continues to clarify how this plays out in practice:

• Induction of labor: Recommendations vary internationally and depend on individual clinical factors such as maternal age, pregnancy type, blood pressure, diabetes status, fetal growth, and overall pregnancy health.
• Second-stage pushing: For many first-time birthing parents using epidural analgesia, routine delayed pushing does not improve vaginal birth rates and is associated with increased risks, including infection and postpartum hemorrhage. Timing is best guided by maternal and fetal status.

Across care settings, guidance emphasizes shared decision-making, clear communication of benefits and trade-offs, and flexibility in clinical management.

Teaching reflection
This evidence supports focusing on how decisions are made, as well as which options may be offered. Teaching can help families understand why recommendations may differ, normalize appropriate use of interventions, and build confidence in shared decision-making. 

Sources

• World Health Organization – Intrapartum Care for a Positive Childbirth Experience
  https://www.who.int/publications/i/item/WHO-RHR-18.12
• National Institute for Health and Care Excellence (NICE) – Intrapartum Care Guidelines
  https://www.nice.org.uk/guidance/cg190

Birth Practice 5 — Avoid Giving Birth on the Back and Follow the Body’s Urges to Push

Upright and lateral positions continue to be supported for comfort and pelvic mechanics. Guidance increasingly reflects the value of physiologic pushing, particularly when epidural anesthesia is not in use, while recognizing that clinical context and individual needs shape how pushing unfolds.

Teaching reflection
Encouraging body awareness, flexibility, and responsiveness remains well aligned with evidence and supports this Birth Practice across a wide range of birth settings.

Sources

• World Health Organization
  WHO Recommendations: Intrapartum Care for a Positive Childbirth Experience
  https://www.who.int/publications/i/item/WHO-RHR-18.12
• Cochrane Database of Systematic Reviews
  Maternal position during the second stage of labor for women without epidural anesthesia
  https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002006.pub4/full
• Cochrane Database of Systematic Reviews
  https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009124.pub2/full

Birth Practice 6  —  Keep Parent and Baby Together: It’s Best for Both

This practice is increasingly supported by evidence that extends well beyond the immediate hours after birth. Current guidance emphasizes postpartum care as a continuum, with planned follow-up and support in the days and weeks following discharge.

Evidence highlights that early postpartum contact and continued assessment support feeding, bonding, emotional well-being, and early identification of concerns for both parent and baby. Skin-to-skin contact, rooming-in, and responsive feeding practices are most effective when supported after discharge through lactation care, newborn follow-up, and attention to parental mental health.

Teaching reflection
This evidence supports weaving postpartum care directly into teaching about Birth Practice 6. Helping families anticipate continued support, understand the connections between feeding, bonding, and mental health, and recognize postpartum care as part of caring for both parent and baby strengthens confidence and continuity.

Sources

• National Institute for Health and Care Excellence (NICE) – Postnatal Care Guidelines
  https://www.nice.org.uk/guidance/ng194
• World Health Organization
  https://www.who.int/publications/i/item/WHO-MCA-17.06

Final thoughts

The Lamaze Six Healthy Birth Practices continue to endure because the evidence continues to support them, often with greater clarity and nuance than when they were first articulated. Keeping curricula reflects respect for families, confidence in science, and trust in educators’ ability to translate evidence into learning that truly matters.

When teaching is grounded in both long-standing principles and updated guidance, families receive education that feels steady, credible, and relevant to their real lives. In 2026, Lamaze childbirth education remains powerful because it grows alongside the evidence, stays rooted in physiologic birth, and continues to center informed, supported families at every step.

Pregnancy nutrition is particularly vital as pregnancy is one of the most nutritionally demanding periods of a woman's life.

Your health and the development of your baby may be significantly impacted by everything you eat during this time. When you’re pregnant, the food you eat feeds both you and your growing baby. Eating nutritious food isn’t just good for you and your baby, but it can also ease some of the discomforts you can encounter during pregnancy. So, it’s essential to keep a close eye on your daily food intake and ensure that it meets all the necessary aspects of health and nutrition.

With this Complete Guide, you’ll find simple and easy-to-understand information about pregnancy nutrition. You’ll learn which nutrients matter most, how much you need, and ways to get them through food. Whether you just found out that you’re pregnant or you’re already in your third trimester, you’ll discover new approaches that will benefit you and your baby.

Remember, good pregnancy nutrition is a gift you give to yourself and your baby.

Get ready for birth with confidence — Join a Lamaze online class today!  Empower yourself with evidence-based knowledge and support every step of the way.

Lamaze Certified Childbirth Educators have been clear about one of the things they need most: ready-to-use, Lamaze-branded materials to help promote their classes and credentials online. We heard you, and we’re thrilled to share a new resource designed especially for you, the Lamaze LCCE Social Media Toolkit.

This toolkit was created with one goal in mind: to make it easier for you to connect with parents, fill your classes, and show the world the power of Lamaze.

Why This Matters

Today’s parents turn to social media first for answers, ideas, and connection. When Lamaze shows up consistently online, through our educators’ voices and classes, more families discover evidence-based childbirth education. That increased visibility means more filled classes for you and stronger recognition of your Lamaze certification.

The truth is, every post helps. Whether it’s a myth-busting tip, a gentle reminder to register for an upcoming class, or a warm message about what makes Lamaze unique, your voice makes a difference. When parents see Lamaze educators regularly sharing clear, confident messages, it builds trust and sparks curiosity.

What’s Inside

The toolkit includes customizable Canva templates for infographics, class promotions, banners, and educator profiles — everything you need to make your posts shine. You’ll also find:

• Sample captions and post ideas you can copy, paste, and personalize
• Posting tips to keep your content engaging and consistent
• A suggested posting calendar to help you plan ahead
• Easy resizing tools so your graphics look perfect on Instagram, Facebook, LinkedIn, and Stories

Every element is designed to be simple, flexible, and uniquely you. Add your photo, class details, and contact information, then share with confidence.

Imagine the Possibilities

Imagine sharing a myth-busting post on Monday (“You don’t have to stay in bed during labor, movement helps!”) and a class promotion by Friday, all predesigned, branded, and ready to go. In just a few clicks, you can post something that looks professional, reflects your certification, and reaches the parents who need you most.

Want to highlight your upcoming series? Use one of the bright promotional templates. Want to engage parents between classes? Try a “Did you know?” graphic with a quick comfort measure tip. And when you post about your next session, you can easily add your logo or the Lamaze seal to help families recognize your professionalism and credibility.

These small, consistent touches make a big impact. They keep your name, and Lamaze, front and center in the spaces where parents are already looking for help and community.

How to Access the Toolkit

You can open, customize, and download the templates directly through Canva, no design experience required. Once you’ve updated your graphics, post them to your favorite social platforms and invite parents to learn more or register for your next class.

Together, We Grow the Lamaze Movement

Every time an educator posts, shares, or promotes their class, it strengthens the Lamaze brand and helps more families find trusted, evidence-based childbirth education. This toolkit is one way we’re investing in your success and helping Lamaze educators worldwide grow their reach.

Explore the toolkit and start sharing today, and don’t forget to tag @LamazeInternational in your posts so we can celebrate and amplify your work. Your stories and creativity are what bring Lamaze to life for families everywhere. Let’s fill every feed with confidence, connection, and the spirit of Lamaze.

Access the Lamaze LCCE Social Media Toolkit through your member portal today!

Why Staying Current Matters

For childbirth educators, keeping up with these changes is both professional growth and a meaningful way to serve families. Current, evidence-based content builds trust, reduces anxiety, and makes classes more effective and empowering.

The Challenge of Keeping Pace

Tradition is strong in childbirth education, but medical science and family needs change quickly. Many educators make small, thoughtful updates, such as revising a handout or adding a new comfort measure. While these changes are valuable, reviewing the curriculum as a whole from time to time ensures that families receive information that is both consistent and fully up to date.

A full curriculum review is time intensive, but tools such as curated handouts, professional webinars, updated textbooks, and organizational resources can help you keep your content accurate and effective.

Demographic and Social Shifts Shaping Education

Declining Birth Rates and Changing Families
Fewer people are having children, and many who do have limited experience with babies. Classes often serve as both educational spaces and sources of community. More parents are giving birth over age 35, with higher risks of hypertension or gestational diabetes. Family structures are also more varied, including unmarried partners, polyamorous families, and multi caregiver households.

Increasing Diversity and Inclusion Needs
Parents represent a wider range of racial, cultural, and gender identities. Disparities in outcomes for families of color persist, making culturally sensitive teaching essential. LGBTQIA+ visibility is expanding, particularly among younger generations, making inclusive language such as “birthing parent,” “chest feeding,” and “human milk” important for ensuring families feel seen and respected.

Rural Obstetric Deserts and Policy Shifts
More than one third of U.S. counties lack local birthing facilities, leaving many families without accessible care. Online education and tele-support are critical lifelines in these regions. Changing Medicaid coverage and state level reproductive policies also affect how families plan their care and where educators must focus attention.

Teaching Families to Navigate Information

Parents are inundated with information, much of it contradictory or commercially influenced. Educators play a key role in teaching families how to assess sources.

Encourage them to ask:
- Who is providing this information, and what are their qualifications?
- Is there a financial or ideological agenda?
- Does the content use fear based language or lack citations?

By building critical thinking, families gain confidence not only in pregnancy and birth but also in early parenting decisions.

Shifting the Emphasis: Risks to Protective Factors

Traditional education often emphasizes risks, which can heighten anxiety. A protective factor approach shifts the focus to what families can do to improve outcomes, such as balanced nutrition, safe physical activity, consistent prenatal care, and strong social supports.

This resilience- based model strengthens self-efficacy, helping families feel capable and prepared while still acknowledging individual risks. It mirrors public health trends showing positive, strength-based education is more effective than fear-based messaging.

Key Updates in Pregnancy Care

Pelvic Floor Health
Pelvic floor care includes both strengthening and relaxation. Awareness, breath, and tension release alongside Kegels can improve comfort in labor and recovery.

Nutrition and Choline
Alongside folate, iron, iodine, and DHA, choline has emerged as essential for fetal brain development. ACOG recommends 450 mg per day during pregnancy, though many prenatal supplements lack it.

Weight and Gestational Health
Gestational weight gain targets are now individualized. For people with obesity, the Institute of Medicine range is typically 11 to 20 pounds, with shared decision making to balance maternal and fetal health. Screening for gestational diabetes is recommended for all between 24 and 28 weeks, with earlier testing for those at risk. Low dose aspirin, 81 mg daily, is recommended for individuals at high risk of preeclampsia, starting ideally before 16 weeks.

Labor and Birth Practices

Admission Guidelines
Policies increasingly aim to delay hospital admission until active labor when safe. ACOG defines active labor as beginning at 6 cm dilation. Educators can help parents understand labor patterns and when to call their clinician.

Comfort and Positioning
Mobility and a variety of labor positions, including upright and side lying, are encouraged to support comfort and physiologic birth. Peanut balls and similar tools may also facilitate progress, but the emphasis is on movement and individualized choice.

Pushing and Third Stage
Routine delayed pushing with epidurals is no longer recommended, as evidence shows limited benefit and possible risks. Coached pushing at full dilation is supported for many nulliparas with epidurals. In the third stage, prophylactic oxytocin and uterine tone assessment are standard. Routine sustained uterine massage is not recommended when Pitocin is given.

Continuous emotional and physical support during labor, whether from a partner, friend, or doula, is consistently linked with better outcomes. This reinforces the Lamaze practice of encouraging families to bring a supportive companion into the birth space. Lamaze also encourages upright positions and working with the body’s natural urges whenever possible, even when epidurals are used.

Labor Practices: Past vs. Current This aligns with the Lamaze practice of letting labor begin on its own and avoiding unnecessary interventions. This reflects the Lamaze practice of moving and changing positions in labor, supporting both comfort and progress.

Induction of Labor

Induction rates are increasing. For some conditions, timing depends on age and health status. Many with well controlled diabetes deliver at 39 weeks. People aged 40 or older may be offered delivery at 39 weeks. For twin gestations, timing is based on chorionicity and clinical factors, often between 37 and 38 weeks.

Educators can prepare families to ask about cervical readiness, expected length of induction, and the support needed for longer processes.

Newborn Care and Feeding

Immediate Care
Delaying the first bath at least 24 hours protects the skin barrier and helps with temperature regulation. Pulse oximetry screening for critical congenital heart disease is now standard.

Feeding Practices
Inclusive language such as “chest feeding” and “human milk” is recommended. Breastfeeding education emphasizes laid back positioning and self-attachment. For bottle feeding, paced feeding supports healthy feeding behaviors.

Lactation Science
Blocked ducts are now reframed as inflammatory processes. Best practice is gentle care, cold compresses, NSAIDs when appropriate, and avoiding deep massage. 

In the past, nipple pain during breastfeeding was often assumed to be caused by yeast, and antifungal medication was prescribed as a first response. Current evidence shows that many cases of nipple pain resolve on their own or are related to other causes such as positioning, latch, or inflammation rather than fungal infection.

Observation and gentle supportive care are now recommended before turning to antifungals. This approach reduces unnecessary medication, avoids potential side effects, and helps families focus on practical strategies such as improving latch, ensuring frequent effective feeds, and using comfort measures.

Postpartum Care and Mental Health

ACOG now recommends contact with a provider within 3 weeks postpartum and a comprehensive visit no later than 12 weeks. Those with hypertensive disorders or gestational diabetes may need earlier or more frequent visits.

Educators can normalize the wide range of postpartum experiences, including physical recovery, changes in intimacy, and mental health challenges. Encouraging open communication and self-compassion helps families build resilience. Awareness of resources gives families confidence to navigate this complex period.

Practical Teaching Tips

- Provide handouts highlighting what is new compared to what is well established.
- Use activities to compare induction methods or labor positions.
- Show diverse video demonstrations of labor and infant care.
- Offer hybrid or online formats for underserved families.
- Stay current through webinars, journals, and organizational updates.

Conclusion

Excellence in childbirth education comes from keeping curricula current and evidence based while staying rooted in what matters most to families. Childbirth education must continue to evolve with new research, shifting demographics, and the realities of diverse families. By embedding critical thinking, highlighting protective factors, and presenting inclusive, evidence-based updates, Lamaze Certified Childbirth Educators can ensure their teaching remains both relevant and impactful.

The true goal is to provide the latest science backed information and to walk alongside families in ways that leave them feeling capable, supported, and confident as they step into birth and parenting.

Update your curriculum with the latest evidence-based information right HERE.

References

ACOG. (2024). First and Second Stage Labor Management Clinical Practice Guideline. https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2024/01/first-and-second-stage-labor-management

ACOG. (2023). Nutrition During Pregnancy. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy

ACOG. (2020). Gestational Diabetes Mellitus. Practice Bulletin. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/02/gestational-diabetes-mellitus

ACOG. (2018). Optimizing Postpartum Care. Committee Opinion. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care

ACOG. (2018). Physical Activity and Exercise During Pregnancy. Committee Opinion. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/04/physical-activity-and-exercise-during-pregnancy-and-the-postpartum-period

ABM Protocol #36. (2022). The Mastitis Spectrum. Academy of Breastfeeding Medicine. https://www.bfmed.org/protocols

AAP. (2024). Delaying Newborn Bathing. HealthyChildren.org. https://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Delay-Newborns-First-Bath.aspx

AAP/CDC. (2018). Critical Congenital Heart Disease Screening Using Pulse Oximetry. https://www.cdc.gov/ncbddd/heartdefects/cchd-facts.html

March of Dimes. (2023). Nowhere to Go: Maternity Care Deserts Across the U.S. https://www.marchofdimes.org/research/maternity-care-deserts-report.aspx

Discover the six simple steps to a safe and healthy birth. Enroll in Lamaze’s Safe and Healthy Birth online class and take charge of your birth experience.

Every Lamaze Certified Childbirth Educator has a story—one that begins with curiosity and a desire to make a difference for expecting families. Your journey might begin the first time you support a friend during pregnancy, or perhaps your own birth experience opened your eyes to the importance of quality childbirth education. Whatever brought you here, the journey to becoming an educator is one filled with learning, growth and purpose.

Whether you are just beginning to explore the idea or are ready to jump in, here is a clear roadmap to guide your journey from student to Lamaze educator.

Step 1: Enroll in Training

The first step is a leap of commitment. You are choosing to invest in your skills so you can guide others through pregnancy and birth. Enrolling in a Lamaze Childbirth Educator Seminar is like opening the first chapter of a new book. You will dive into evidence-based strategies, discover the Lamaze Six Healthy Birth Practices and learn the art of guiding parents through one of life’s biggest transitions.

Step 2: Prep for and Pass the Exam

After training, your focus shifts to earning your Lamaze Certified Childbirth Educator (LCCE) credential by completing the application and taking the LCCE exam. This is where your knowledge, teaching skills and passion all come together. The Lamaze Educator Learning Guide is an invaluable resource to help you study, review key concepts and feel ready for exam day. Some trainers also offer study groups, which provide a supportive environment to discuss material, ask questions, and prepare alongside fellow aspiring educators. Passing the exam is both a milestone and a celebration—it marks your official entry into the Lamaze educator community.

Step 3: Build Your Curriculum

With your certification in hand, you can begin creating engaging, effective classes. The Navigating Pregnancy & Birth: Your Lamaze Curriculum gives you a strong framework to ensure your teaching is clear, evidence-based, and parent-focused. This is the stage where your personality and teaching style shine through, making your classes both educational and memorable.

From role-playing breathing techniques to guiding discussions about birth preferences, you start to see your lessons come alive.

While using the Lamaze Curriculum is recommended, some educators choose to build their own curriculum. This approach allows for complete creative freedom but requires a tremendous investment of time, resources, and skill to ensure it meets evidence-based standards and effectively engages parents.

Step 4: Market Your First Class

Now it is time to spread the word. Marketing your first class can feel like a big leap, but you are not alone. The Lamaze Connecting the Dots blog offers tips, inspiration and strategies to help you reach expectant parents, build connections in your community and get those first students enrolled. You’ll also find support, tips and encouragement in the Lamaze Childbirth Professionals Facebook group. 

Step 5: Teach Your First Class

At last, the moment arrives, and you are standing in front of your first group of parents-to-be. You might feel a few nerves, but you are ready. With the Lamaze PowerPoint, you have a professional, evidence-based tool to guide your teaching and engage your students. And providing clients with the Lamaze Parent Guidebook, you’ll feel confident that parents have a take-home reference to build on their learning.

Seeing parents’ eyes light up when they understand a concept for the first time is unforgettable. As they ask questions, share stories and begin to feel more confident, you realize that you are not just teaching; you are making a lasting impact on families in your community.

Becoming a Lamaze Certified Childbirth Educator is more than a career move—it is a calling. Each step on the roadmap brings you closer to fulfilling your dream of empowering families with knowledge, confidence, and support during one of the most meaningful times in their lives. And that is a journey worth taking.

When I reflect on my 50-year journey as a Lamaze educator, I’m reminded of the power that knowledge brings—especially during one of life’s most transformative moments: childbirth.

My passion for childbirth education began with my own first birth experience. Even though we took Lamaze classes, there was little support from physicians and hospital staff for “natural” birth. My labor was induced, and I was given scopolamine—causing my spouse to be sent to the waiting room. I have no memory of labor, birth, or even meeting my son for the first time after his cesarean delivery. That experience left me feeling disconnected, disempowered, and uninformed. It ignited a lifelong commitment to ensure others would never walk into birth feeling powerless or alone.

Seven years later, I gave birth to my second child—a beautiful, unmedicated VBAC. That birth experience was everything my first was not: empowering, clear, and unforgettable. I felt supported, informed, and truly present as I welcomed my baby into the world. It reaffirmed what I knew in my heart: that every birthing person deserves access to information, options, and respectful care. That experience further fueled my passion for helping families understand their choices and recognize the power they hold in shaping their own birth stories.

Two years after my first birth, I became certified as a Lamaze educator while still in nursing school in 1976 and began teaching soon after—first in a co-op and private practice, then at the first freestanding birthing center in San Antonio. Eventually, I had the opportunity to design and lead a comprehensive perinatal education program for a major hospital system. Grounded in Lamaze principles, it offered more than just classes. We held women’s health events, lunchtime learning sessions, and developed a robust inpatient and outpatient lactation support program staffed by International Board-Certified Lactation Consultants (IBCLCs). These were fun times of change as we advocated for family centered maternity care in a conservative maternity culture as childbirth educators and inspired parents to demand positive changes. 

After retiring from nursing, I continued using my experience by opening a maternity boutique in Wilmington, NC, called The Woman’s Place. There, I offer Lamaze and Spinning Babies classes, breastfeeding and newborn care instruction, lactation services, and a carefully curated selection of birth and breastfeeding-related items—along with cute maternity and children’s clothing.

To new Lamaze educators: think outside the box. You may find yourself teaching in hospitals, homes, boutiques, online platforms, or community centers—each space offers a chance to meet people where they are. Birth in our society is constantly shifting, with medical, cultural, and political forces influencing how people experience it. Ride those ups and downs, stay grounded in evidence, and above all, continue advocating for birthing families. Your voice matters—use it to help others find theirs. 

Throughout my career, my goal has remained the same: to encourage expectant parents to learn about pregnancy, birth, and breastfeeding so they can engage in informed, shared decision-making with their care providers. Lamaze isn’t about promoting a single “right” way to give birth—it’s about equipping families with evidence-based information and confidence.

Birth matters. Education matters. When parents feel informed and supported, their experience—whatever path it takes—can be one of strength and joy. After five decades in this work, I am still honored every time a parent tells me, “I didn’t know I had a voice—until your class helped me find it.

From our blog to our classes, with the Six Healthy Birth Practices as our foundation, Lamaze strives to prepare parents to make informed decisions. We believe that an informed pregnancy is an empowered pregnancy. That commitment shows up not only in what we teach, but in how we teach it.

That’s why we’re so excited to share the brand-new Plumtree Baby Lamaze teaching materials. These thoughtfully designed resources are game changers for both new and seasoned Educators. Whether you’re launching your first series or looking to refresh your longtime approach, these tools help you bring evidence-based, respectful, and transformative education into every classroom.

A Closer Look at the New Tools

1. Navigating Pregnancy Birth – Your Lamaze Curriculum

This downloadable curriculum is a flexible, complete roadmap. It includes a full 8-hour lesson plan, more than 30 handouts, as well as interactive activities and discussion prompts that directly align with Lamaze Essential Content. The comprehensive structure allows you to tailor your teaching approach while staying grounded in best practice.

Why it makes a difference:
* If you're just starting out, this gives you confidence and structure right out of the gate.
* If you've been teaching for years, it cuts your prep time dramatically and ensures your material reflects current Lamaze standards.

2. Navigating Pregnancy & Birth PowerPoint

With 157 clean, visually engaging slides, this presentation covers all the essentials—pregnancy, labor, interventions, postpartum, newborn care, and breastfeeding. The content is designed for in person or virtual classes and can be rearranged to meet your specific teaching goals.

Why it helps you teach better:
* Thoughtful graphics and concise content help parents stay engaged and retain more.
* Prompts built into the slides encourage real conversation, not just lecture.

3. Navigating Pregnancy & Birth Parent Guidebook

This full-color, inclusive, and easy-to-follow guide is the perfect take-home companion for parents. It mirrors the class content and reinforces the Six Healthy Birth Practices in a way that feels approachable and practical.

Why parents love it:
* It’s readable, relevant, and respectful of diverse families and experiences.
* It keeps the learning going long after your class ends.

4. Lamaze Starter Package

Want it all? The Starter Package combines the curriculum, slide deck, and a parent guide at a lower bundle price. One order sets you up with everything you need to deliver a complete, polished class.

Why It Matters

Lamaze has always stood for more than just childbirth classes. Our three pillars: evidence-based, respectful, and transformative, define everything we do. These new materials reflect that heart and purpose. They allow educators to focus less on logistics and more on connection. Less time formatting means more time empowering parents.

Ready to Refresh Your Toolkit?

Whether you’re building your class from the ground up or just need a few new pieces, these resources were created to support you. The best educators never stop learning and with these tools, you can keep evolving while staying true to what makes Lamaze so trusted.

Explore the new materials at plumtreebaby.com or on the Lamaze Teaching Resources page.

We can’t wait to see how you make them your own.

Let’s keep teaching in a way that informs, respects, and transforms.

To anyone walking this path, I want you to know that you’re not alone. The journey to parenthood isn’t always smooth, and it doesn’t have to look perfect. Take it one step at a time, and know that it’s OK to grieve while holding onto hope. You are stronger than you realize, and even in the darkest moments, there’s light ahead.

Your story isn’t over yet. Keep fighting, keep hoping, and remember that you’re not alone in this.

Rachell Dumas, RN, is a nurse entrepreneur, maternal health advocate, pregnancy survivor, and founder of “A Light After Nine”, a nonprofit dedicated to supporting families through pregnancy loss, infertility, and maternal trauma. After enduring nine pregnancy losses, Rachell turned her pain into purpose by advocating for equitable, compassionate maternal healthcare.