As I prepare to take my LCCE exam I am doing a lot of reading and research. One of my (MANY) required readings is from this article:
Commentary — Chronic Moral Distress Among Childbirth Educators: Is There a Cure?
Marilyn Curl, RNC, CNM, LCCE, FACCE.
You can read the entire article published in the The Journal of Perinatal Education here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2667296/
but here is the part that I found most interesting, or rather, disheartening…
A more recent study by Carlton, Callister, and Stoneman (2005) examined the decision-making processes among laboring women. Of interest to childbirth educators is the researchers’ observation that ‘‘generic hospital-based perinatal educational offerings served to orient women to hospital routines’’ and failed to educate them ‘‘about the risks and benefits of available options’’ (p.150). Such statements contribute to the moral distress experienced by educators whose influence is too often limited by powerful others. The common stories of these educators consistently include the following themes:
- Employers insist information presented in class must reflect hospital practice, not necessarily best practice.
- Class size is driven more by a desire to contain cost than by a desire to provide quality instruction.
- Instructors are directed to include educational materials produced by feeding-formula companies, cord-blood registries, and makers of disposable diapers.
- Class time is diminished by mandates to include guest speakers—most commonly anesthesiologists,who tend to provide a one-dimensional view of pain management.
- Health-care providers give class participants information that is in conflict with current evidence, placing instructors in an awkward position.
To complicate the issue further, consumer attitudes have shifted, with women viewing childbirth classes as a ‘‘burden,’’ despite the best efforts of educators (Tiedje, Price, & You, 2008).

