"A lot of women have no idea what they want, in childbirth, before they start classes," says Penny Simkin, a highly respected professional in the field of childbirth and labor support. "And they are assuming they are going to learn that from their teacher. And a lot of people aren't aware that there's a tremendous amount of bias in education, and there's very little true neutrality on the part of most childbirth educators, as well as caregivers. That's kind of a shock to expectant parents, I think. They sort of assume that the doctor is the expert, knows what to do, and will give the safest and best care, and have little expectation that they have a tremendous amount of choice in where they're going to give birth, what kind of care they're going to get and even the choices that are made during the labor.

"I think it would be important to try to find an educator who does present those options. And who has some independence. If her salary is being paid by a group of physicians, or a hospital, it's harder for her to offer a wide range of choices and an unbiased point of view. So I think an expectant parent should ask questions such as, what options do you think are viable? If they are interested in learning about natural birth, or whether there are harmful side effects to epidurals or narcotics, or if they are interested in water birth or midwifery, they should ask the educators whom they interview if those things are discussed in class."

As an educator, Simkin has this to say about her own teaching style, and other birth education methods, such as Bradley and Lamaze: "I started out teaching a method called the Erna Wright method, and then switched over to Lamaze, back in about 1970. Those methods [Lamaze and Bradley] are OK, but neither one is suitable for everybody. And to be honest, at the time, there was a huge rivalry between those two groups over exactly how you should be breathing, and trashing any other way of breathing. I observed women coping, tried to figure out what they had in common, and that's what I've tried to emphasize in my teaching.

"I bought into that for a while, and then I realized how ridiculous I was [for] insisting on the Lamaze chest breathing. If you can believe it, I used to try to get people who were abdominal breathers to breathe with their chests. And then I finally realized, she's relaxing, what difference does it make?

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