Activities for Transition to Parenthood Sessions

Mary Nolan, PhD MA BA RGN

The following are examples of activities that might be used in transition to parenthood sessions to build group members’ capacity to have the labour they want to have and to be the best parents or co-parents they can be. All the activities are underpinned by the recognition that adult learners are not ‘blank slates’; they have had many experiences in their lives, and acquired a great deal of information, that can be transferred to the new experience of becoming a parent or co-parent for the first time, or for a subsequent time.

 

Recognizing and Valuing People’s Strengths as Parents

Aim: To give group members confidence that they already have skills and qualities that will help them when they become parents/co-parents.

Learning Outcomes: Having participated in this activity, group members will be able to:

  • Acknowledge their strengths as individuals and as parents or co-parents
  • Describe the qualities of a ‘good’ parent
  • Identify what babies need in order to thrive physically, socially and emotionally

Activity: Ask each person in the group to say (to the group or the person next to them), or to write down, something they feel they are good at in life or a positive quality that they have. Give examples to guide the process e.g. ‘I’m an organized person’; ‘I have a good sense of fun’.

Participants’ ideas may include:

  • Good at managing on very little money
  • Good at my job
  • Good at helping my friends when they’re having problems
  • Good at planning events
  • Love meeting new people
  • Like learning
  • Easy to be with
  • Have lots of experience with children because I’m part of a large family
  • Always do what I say I’ll do
  • Have lots of energy

Ask the group how these skills and qualities will help them as a parent. This should start a discussion on what makes a good parent and what babies really need to be happy and healthy.

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Building on what Group Members Already Know: A Model for Information Sharing  

The following is an example of how to elicit and build on what the group members already know about a particular topic. Imagine that the topic for the transition to parenthood session today is labour. The midwife starts by drawing out what group members have been told about labour by friends and family members. S/he then validates the experiences that have been shared and emphasizes key learning, namely that it’s quite normal to be uncertain about whether labour has started. S/he adds a little more information to what has already been shared and moves on to exploring group members’ anticipated feelings about the start of labour. After allowing some time for discussion, s/he moves the group on to consider when they would want to go to hospital or the birth centre. This is always a key concern of the people who are going to be supporting the mothers during labour. S/he then offers a few minutes for the pregnant woman and whoever has come with her to the session to share their private views on when is best to go to hospital. Finally, the midwife signposts group members to further information if they want it.

So the model is:

  • Draw out what group members already know on the topic.
  • Validate correct information and acknowledge every experience of labour that has been shared (nobody’s experiences are ‘wrong’ although they may be unusual).
  • Add more information if needed (remembering that adult learners want information on a ‘need to know’ basis and do not want to be overloaded with facts).
  • Facilitate discussion of feelings.
  • Ask key questions (and wait for answers; avoid providing them yourself).
  • Provide an opportunity for private discussion between the pregnant woman and her companion.

Aims: To strengthen the pregnant women’s and their birth companions’ belief in women’s innate understanding of labour and birth and to enhance communication between the pregnant woman and her birth companion.

Learning Outcomes: Having participated in this activity, group members will be able to:

  • Describe the signs of labour
  • Understand that early labour may be a period of uncertainty for the pregnant woman and her companion
  • State when they anticipate going into hospital/attending the birth centre/calling the midwife (if they are having a home birth)

Example: The discussion might run like this:

Midwife What have your friends told you about how labour starts? Or what has your mother told you happened when you were born?
Group member #1 My friend said they weren’t really sure whether this was ‘it’; that it just felt like period pains.
Group member #2 My sister was having contractions for hours and hours but the midwife wouldn’t admit her to the hospital.
Group member #3 I think my mother said her waters broke and she had a bloody show?
Midwife Well, everything you’ve mentioned is right. And especially the comment about not being sure whether labour’s begun; that’s a very common experience. Often the mother has mild pains low in her tummy or in her back at the start of labour and these can last a long time, although some people go into strong labour very quickly. And, yes, some women have a show and for some, the start of labour is their waters breaking.How will you feel when you think that labour has started?

Encourage class discussion

Midwife And when do you want to go to the birth centre? As early as possible or as late as possible?

Encourage class discussion

 Midwife Just take two minutes now to share your feelings with your companion about when to go to the birth centre or hospital. It will be helpful to understand how you each feel when the big day actually comes.

Small group work in couples (i.e. the pregnant woman and whoever has come with her to the session)

Midwife Thank you. There’s lots more information on the internet about how labour starts. I’ve got a list of reliable websites that I’ll give you at the end of the session. Let’s move on now to what happens later on in labour.

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Who Does What?

Aim: To strengthen the relationship of the two people who are going to look after the baby by anticipating sources of conflict following the birth

Learning Outcomes: Having participated in this activity, each couple will be able to decide how they will manage household and baby care tasks after the baby is born

Activity: Give each pregnant woman  a pack of cards which includes three header cards:

  • I will do this
  • You will do this
  • We will both do this

On the other cards are pictures of everyday activities such as doing the washing up, shopping, cleaning the bathroom, changing the baby, feeding the baby, playing with the baby, paying bills, etc. The pregnant woman and companion are then invited to place each activity card under one of the three header cards.

There is no right or wrong way of sorting the cards. The value of the activity lies in the discussion that the pregnant woman has with their non-pregnant partner or companion about managing their lives after the baby is born.

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Helping Group Members Think about Support in Labour and the Physical Environment

The following is an activity that will appeal to group members who are strongly visual learners. This doesn’t mean that the activity won’t also appeal to other group members who might be primarily auditory or kinetic learners. Everyone can and does learn visually, and as long as you are providing a range of activities, you will be catering for everyone in your group.

Aim: To support the pregnant women and their birth companions to make decisions about the environment of labour and what kind of support the women want and their companions can provide

Learning Outcomes: Having participated in this activity, group members will be able to:

  • Describe the physical environment of the labour room in a hospital or birth centre, and strategies for making it as comfortable and relaxing as possible for the labouring woman and her birth companion
  • Identify a range of positions, upright and reclining, which a labouring woman might find helpful and which will make her labour as efficient as possible
  • Identify the kind of support that birth companions might offer

Activity: Lay out a series of realistic pictures of labour that include the labourer and birth companions.  Ask the group to discuss their responses to each picture. Use prompts to get people talking:

  • What strikes you about this picture?
  • Have you thought about labouring in this position?
  • How is this mother being supported?
  • How could the labourer and companion make themselves comfortable in this room? What comfort items could they bring from home or ask the midwife to get for them?

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What Kind of Parent do I Want to Be?

Aim: To promote sensitive parenting

Learning Outcomes: Having participated in this activity, group members will be able to:

  • Identify parental behaviours that enable babies and young children to flourish physically, socially and emotionally
  • Identify parental behaviours that might undermine very young children’s trust and self-esteem
  • Identify the everyday stresses that parents face, such as tiredness, that can contribute to insensitive behaviour towards their babies and small children
  • List sources of support for parents, such as family members and friends, health and social care professionals, parent and baby groups, infant feeding groups, postnatal exercise sessions etc.

Activity: If the group is large, split it into smaller groups of about four people. Ask each group to share examples of when they have seen parents behaving well, that is, demonstrating what the group members each consider to be excellent parenting. If the group includes someone who is confident to write, ask them to write down the group’s ideas.

After about five minutes, ask the groups to discuss examples of when they have seen insensitive parenting.

Then ask the small groups to reform as a single group and invite them to share their ideas about what constitutes sensitive parenting and what kind of parenting might be harmful to babies and small children. Discuss why parents might sometimes not be the great parents they would like to be. You could lead the discussion towards addressing the stresses that new parents face and where they can find support.

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Bathing the Baby

Aims: To build the confidence of parents-to-be that they will be able to care for their baby. To develop an appreciation that providing physical care to a baby is also an opportunity for interaction with the infant.

Learning Outcomes: Having participated in this activity, group members will be able to:

  • Undress, safely bath and dress a baby
  • Identify items of baby equipment commonly sold in shops that are not suitable for use with babies
  • Understand the importance of talking to their baby

Activity: If possible, provide every couple in the group with a doll dressed in a diaper, vest and snap onesie and with towels and cotton wool balls. You need the same.

Start by laying out items that are often used when bathing and changing babies such as baby soap, baby shampoo, talcum powder, ear buds (cotton swabs e.g. Q-tips®), bath support, nappy/diaper cream, etc. Ask the group which items they think are essential when bathing a baby. Without making anyone feel foolish, explain that none of these is essential and some can be harmful, such as talcum powder and ear buds , and offer to show the group how to bath a baby safely and effectively.

Demonstrate how to undress, bath and re-dress a baby. Invite all the group members to work alongside you so that as you do something, they are copying you. Encourage questions. Emphasize how important it is to talk to the baby as s/he is being bathed as this is a wonderful time for interaction.

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Breathing through Contractions

Aim: To boost group members’ confidence that they have resources for coping with the intensity of contractions.

Learning Outcomes: Having participated in this activity, group members will be able to:

  • Use their breathing to control stress and remain as relaxed as possible during contractions
  • Understand how to support a labouring woman to breathe well during contractions
  • Appreciate how long a mid first-stage contraction might be

Activity: If possible, have a candle available to light. Then demonstrate taking a calm in-breath and breathing out gently through the mouth so as to make the candle flame flicker. Invite group members to close their eyes and practise similar breathing with a slow intake of breath and gentle out breath through the mouth. Ask them to keep the candle flame in mind and to imagine making it flicker but not extinguishing it as they breathe out.

Ask group members how this felt.

Then invite them to practise again, and on this occasion, time 40 seconds (or 30 or 60) to give them an idea of what breathing in this way through an average length contraction (mid first stage) might be like.

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A Script for Practising Relaxation

Aim: To nurture a healthy pregnancy

Learning Outcomes: Having participated in this activity, group members will be able to:

  • Understand how their bodies feel when their muscles are tense and when they are relaxed
  • Practise relaxation as a pregnancy and parenting strategy for maintaining physical and mental health

Example: The following script for practising relaxation in a transition to parenthood class appears courtesy of the author from her own publication (cited below). Note the deliberate use of both ‘he’ and ‘she’ in this script.

Shut your eyes if you want to. I am looking down and not watching any of you. I won’t look up until the end of the session. If you don’t want to close your eyes, that’s fine. If your eyes start to feel heavy at any point, let them gently close.

Become aware of your own breathing. The in-breath and the out-breath. Your breathing is rhythmical. If your attention wanders away from your breathing, bring it gently back to your in-breath and your out-breath.

Now, every time you breathe out, imagine that your breath is carrying away all your tension.

Think about your legs and as you breathe out, let your legs feel heavy, your feet firmly in contact with the ground, and your thighs rolled slightly apart.

Think about your tummy. There’s no need to hold it in tightly. As you breathe out, feel your tummy relaxing.

Think about your hands and arms. So much tension can accumulate in your hands. As you breathe out, let your fingers become gently curled; even your thumbs are slightly curved, and your elbows are resting against your body.

Think about your shoulders. As you breathe out, let your shoulders sink downwards, so that they feel loose and easy.

And finally, think about your face. You have lots of muscles that work your face but now, as you breathe out, let the expression on your face slip away so that your forehead is smooth, your jaw loose and your mouth perhaps slightly open.

Spend a moment appreciating how your body feels when it is truly at ease. If any part feels tense, use your out breath to cleanse the tension, letting it slip away as you breathe out.

Now you have time to think about your unborn baby. Your baby is warm inside the mother. He or she is hearing sounds which have become very familiar – mother’s heartbeat; mother’s and father’s voices; perhaps the voices of other family members who have been around during the pregnancy; the sound of blood flowing through the placenta.

Your baby is cuddled by the walls of the womb – when he stretches out his arms, he feels the soft contours of his mother’s body. When he is born, he will be surprised by the space around him and will be soothed by being held close to you.

Your baby is fed on demand while she is inside. Her food is brought to her and all the waste products are taken effortlessly away. She will be in a very strange new world when she’s born and has to ask for food and tell you when she’s uncomfortable. Feeding her and changing her will soothe her.

Your baby is uniquely your special child. He knows the two of you and has a relationship with you that no-one else can have in quite the same way.

When he is born, he will be content when you offer him the warmth and the holding that he has experienced in the womb, and when he hears the sounds that he has become familiar with inside his mother. So hold him close to your heart, talk to him, and keep him close to you.

Enjoy a few moments now with your baby……..

Become aware once more of your breathing: the in-breath and the long out-breath. Count through three cycles and then open your eyes and come back into the room.

Nolan, M. Education for calm pregnancy. International Journal of Birth and Parent Education. 2015 2(4):5

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Cesarean Mock-up

Aim: To protect the mental health of clients who need a cesarean, and of their companions, by enabling them to anticipate the physical environment of the theatre and the emotions they might feel

Learning Outcomes: Having participated in this activity, group members will be able to:

  • Understand the range of feelings that mothers and their birth companions might experience if the baby needs to be born by cesarean
  • Identify the medical and para-medical staff who will be present at a caesarean operation
  • Describe the environment of the theatre and the cesarean procedure
  • Anticipate their feelings (whether the mother or the birth companion) before and during the operation
  • Describe how a baby born by caesarean can be welcomed into the world
  • List the support a mother who has given birth by caesarean might need when she returns home

Activity: Introduce the activity by explaining that some babies will need help to be born and that surgery has a part to play in keeping birth safe. Ask the group if they would like to learn what happens during a cesarean.

Invite one of the pregnant group members to spend five minutes sitting with her feet up, to role play being the client undergoing the cesarean. We suggest using a different name for the client during this role play – this prevents the volunteer from feeling that by assuming the role of someone having a cesarean, they will have one themself. (REF  )

Ask the group who will be present in the theatre with the client. As group members name members of the surgical team (e.g. the surgeon; theatre nurse; scrub nurse; operating department practitioner; student; paediatrician) invite them to take up their position around the client.

Draw attention to the number of people present for the operation. Ask the client playing the patient and the person playing her partner how this might make them feel.

Then talk through the operation, inviting the group to consider:

  • What they might see, hear, smell in theatre
  • How long it will be until the baby is born
  • What happens to the baby at birth
  • How the baby can be welcomed into the world
  • How long it takes to stitch the mother’s wound etc.

At the end of the activity, start a discussion about how people might feel if their baby needed to be born by cesarean. (Relieved? Disappointed? A failure?) Ask them to think about what support a client who has given birth by cesarean might need when she comes home.

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Building Mental Health by Helping the Group Develop a Supportive Network (How to use Ice Breakers)

Aim: To build social networks among group participants and enable them to consider their own attitudes and ideas in the light of those of other people.

Learning Outcome: Having participated in this activity, group members will:

  • Know some of the people in the group better

And will be able to do at least one of the following:

  • Describe several easy-to-prepare healthy snacks for themselves
  • List Parent and Baby groups that they could attend for support
  • Identify characteristics of a ‘good parent’
  • Acknowledge some of their worries about becoming a parent

Activity: Split the group into smaller groups. Ask the small groups to remind each other of their names. Then give each one a slip of paper with a question or discussion topic, such as:

  • Can you think of a healthy meal you could prepare in ten minutes while your baby is having a nap?
  • Do you know of any parent and baby groups close to where you live?
  • What do you think makes a good parent?
  • What one thing worries you most about becoming a parent?

You may choose to ask each group to share their ideas, or it may seem better to let the discussions remain private and not share them in the large group. Be guided by how much time you have and whether it would be helpful for group members to share their ideas.

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Ensuring that New Learning is Retained so that it can be Drawn Upon When Group Members Need it: Recap

Aim: To consolidate the learning that has been achieved during the session, thereby making it more likely that it will be remembered when needed.

Learning Outcome: Having participated in this activity, group members will be able to:

  • Identify key learning that they have achieved, whether facts, skills or ideas, that will influence their birth and parenting

Activity: Ask group members to close their eyes for a moment and to take a couple of deep breaths to calm the mind and body. Very briefly, list the topics that have been covered during the session. Ask group members to identify something they’ve learned. Then ask everyone to open their eyes and invite each person to share what they’ve learned.

(This activity will tell you a lot about the learning that has taken place during the session. Listen carefully for what group members have remembered and appear to have found relevant and useful, but also note the topics that were covered during the session which no-one mentions. You might want to think again about these topics and how you are facilitating them to ensure that the intended learning outcomes are being achieved.)

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Reflection – Transition to Parenthood Session 

There are all kinds of formal ways of evaluating a transition to parenthood session. You might ask group members to fill in a questionnaire at the end of each session, or at the end of the programme. You might follow them up after their babies have been born and find out whether the transition to parenthood programme was helpful to them during labour and in the first weeks of their new baby’s life.

You also need to take a few moments after each session to question yourself about the effectiveness of the session. The following questions provide a framework for constructive reflection.

What happened during the session? What were you thinking and feeling during the session?
  • What did you and the parents do during the session?
  • Did you do most of the talking, or did the group members?
  • Was there plenty of movement?
  • Was there a range of learning opportunities to appeal to group members with different learning styles?
  • Did you feel confident throughout? Or nervous? Or even frightened?
  • Were you affected by parents’ stories and/or emotions?
  • Were you able to remain in the moment and immerse yourself in each activity/discussion, or were you constantly thinking ahead to what you would say or do next?

 

What was good and bad about the session?

Good Not so good
  • Parents were involved throughout the session.
  • They interacted with you and with each other.
  • Their body language and comments suggested that they were enjoying the session.
  • You did most of the talking and the group members did not contribute much.
  • It was hard to get them involved in activities.
  • Group members’ body language and comments suggested that they were bored and disengaged.
  • The session over-ran and there was no time for a break in the middle.

 

What sense can you make of the good and not so good aspects of the session?

  • Was it a good session because you were well prepared? Because you had a colleague to support you? Because the parents were attending a second session and already knew each other a little?
  • Was it a poor session because you weren’t properly prepared? Because you didn’t understand the agenda for the session? Because you arrived late? Because it was a new group of parents? Because you gave too much information and didn’t explore the group members’ ideas and feelings? Because the topics covered didn’t seem to be of interest and relevance to the group members?

What could you  do to ensure that the next session is more effective in terms of helping group members engage and learn about becoming a parent?

  • Be better prepared?
  • Be clear about what you want the group to learn, to discuss and to practise?
  • Allow more time for ice breakers to help people get to know each other?
  • Avoid standing all the time, but sit down and be part of the group?
  • Invite more contributions from the group members?
  • Use more small group work to help shy people share their ideas?
  • Identify the key points you want to make on each topic to avoid information overload?
  • Facilitate practical skills work with more confidence?
  • Manage the timing of the session better so that group members can have a mid-way break and still finish the session on time?

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