Increased access to information about birth online – enemy or ally?

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This post is a bit different as it is a recording of my presentation at the Sensitive Midwifery Symposium in JHB, South Africa.  Embracing technology has been hard for me but a couple of years ago I realised that I if I was to remain true to my calling to change birth practices and improve women’s experience of birth then I had to change the way that I was disseminating information and literally get comfortable with apps, tweets, tablets, status updates and cloud computing. I had to find out more about this wireless world where technology knows no boundaries and everyone seems to be constantly logged-on and linked-up. I would love your feedback. Sound quality is not great but the message is clear that the internet is a double edged sword. I discuss the challenge faced by midwives and birth workers to use it effectively.

The internet is a double edged sword, It is either our biggest threat or our biggest challenge. Today I want to guide you to make it your challenge and it will be a challenge because this is a snapshot of what we are dealing with and facing

  1. This is a live stream of what is going on online right now
  2. This is an indication of the rise of internet users in the last 25 years
  3. This is what happens in ONE SECOND every single day.

7,154 tweets

714 instagram phots

119,452 you the videos

2,070 skype calls

33,847 GB of internet traffic

53,488 google searches

2,476,952 emails sent

Now when I grew up – wireless referred to the radio and we would sit around at night as a family and listen to programs – sqaud cars and the mind of Tracey dark srping to mind.  Telephones had cords and most households only had one. I learned to type on a typewriter.

Embracing technology has been hard for me but a couple of years ago I realised that I if I was to remain true to my calling to change birth practices and improve womens experience of birth then I had to change the way that I was disseminating information and literally get comfortable with apps, tweets, tablets, status updates and cloud computing. I had to find out more about this wireless world where technology knows no boundaries and everyone seems to be constantly logged-on and linked-up.

The generation that we are working with – the ones who are pregnant, seeking information and having babies are spending an average of 10 hours per day using technology of some sort. There are over 4 billion youtube views per day, over 5 billion google searches per day and over 1 billion apps in use.

The rise of internet users has grown steadily and exponentially over the last decade and we now have over 4 billion and rising.


If we are to empower women to get the choices, recognition and respect that they deserve in pregnancy and birth, OUR CHALLENGE is to ensure that  we are catering to the increased demand for quality information about childbirth and to

Deliver it in a format that facilitates the principles of adult learning in antenatal education and includes the use of modern technological advances with which as generation z they are so comfortable.


Gen Y & Z would rather watch a video summarising an issue than read an article discussing it. They are global, social, visual and technologically literate generation has been shaped to multitask. They move quickly from one task to another, often placing more value on speed than accuracy. They have only known a wireless, hyperlinked, user-generated world where they are only ever a few clicks away from any piece of knowledge. Messages are increasingly image-based and brands communicate across the language barriers with colour and picture rather than words and phrases.

They comprise nearly 2 billion people globally, and they don’t just represent the future, they’re creating it.


Books, TV, social media, news media have largely  replaced childbirth classes as major sources of information

Many women today are inspired and motivated to have a “natural birth” without understanding how to achieve a natural birth or what a natural birth actually is.

THE purpose of Antenatal edication

  1. provides perspective on the overwhelming amount of information available.
  2. provides guidance and skill in comfort and labor progress measures
  3. provides reassurance and encouragement to balance instinct with technology
  4. provides balanced information to make good choices
  5. improves birth outcomes

Generations Y and Z are the first media consumers to emerge with interactive media as the predominant means by which they ‘consume’ messages. They are the most marketed to of all generations, largely due to technological advances from the Internet to SMS.

Although this means that we have several ways of communicating our messages, the constant interruptions of a technological world means that these generations have shorter attention spans which is why we need to include an element of interactivity in our online teaching and emphasising transactional rather than linear communication processes.

We need to provide a complexity of choice, responsiveness and interpersonal communication in order to engage and retain.

This provides us with the opportunity to tailor our message and maintain a level of interpersonal interaction within our online community.

The single biggest issue with the internet is that it is overloaded and disorganized.

Users may find that search engines locate too many or too few sites, target audiences often are unspecified.

Availability of information on the web is subject to the same disparities as traditional sources.

Even savvy Internet users `can have trouble distinguishing the wheat from the chaff’ [(Rudin and Littleton, 1997), p. 934].

Sonnenberg claims `Most people will be unable to determine the qualifications of Web authors and separate truth from opinion’ and `even well-educated users are unlikely to have the background required to critically evaluate medical information’ [(Sonnenberg, 1997), p. 152].

As a result, consumers lacking evaluation skills are particularly vulnerable.


The auditory classroom delivery style that we have traditionally used for antenatal classes is being replaced by visual and hands on learning styles.

And if we are going to effectively include technology in education women, then we need to find ways of embracing various learning styles and incorporate different learning processes into an effective antenatal program that is available and accessible both online and offline.

Moreover the emphasis must shift from us – as educators – to the women – our learners who have previous life experience and prior knowledge and who have come to use because the outcome they desire is a positive birth experience and we are able to offer an outcomes based program.

Today’s learners are a multi-modal generation and therefore demand communication styles that engage multiple learning channels.

In an era of information overload, messages have increasingly become image based and signs, logos and brands communicate across the language barriers with colour and picture rather than words and phrases. There is a dominance in the visual and hands on learning styles over and above the auditory delivery which traditionally dominated antenatal classes.


Effective engagement in learning environments have moved from verbal to visual, from sit and listen to try and see, from curriculum centred to learner centric.  While in the past the teacher used to be the source of the knowledge, today’s technology access means students have access to any piece of information within a few clicks of a button – so the role of the teacher has changed from the traditional teacher model to a facilitator of the learning.  The focus has shifted from content (what) to process (how) and an open book world.


Consumers can select sites, links and specific messages based on knowledge, educational or language level, need, and preferences for format and learning style, often at lower cost than conventional methods (Pereira and Bruera, 1998).

At the same time, traditional health information and patient education materials and messages can be placed on the Internet inexpensively (Richards, et al., 1998)

So if we are to facilitate health-promoting use of the web among the women that we are serving,  we are going to have to the  implement the strategies, skills, programs, and systems to do so.

If we are committed to changing and improving birth practices then we must teach the women we work with to develop discerning and critical use of technology.


Antenatal education is a crucial component of a holistic approach to good maternal care.

Technology-based learning may have many advantages over a traditional educational setting, however, development of face-to-face education has a unique role to play.

BUT we need to take action now and begin to prepare our student midwives and our midwife educators for this rapidly changing technological field or

The appetite for traditional, face-to-face antenatal education classes may be lost.


If we are truly focused on an outcomes based approach and if the purpose of antenatal classes is to improve maternal health literacy, then what are we doing differently to make sure that women leave our class with the skills and confidence to take a range of actions that contribute to a successful pregnancy, childbirth and early parenting?

How are we making sure that they know where to go to find further information, and that they have the ability to analyse information critically? And how are we going to use the internet to do that?


What women do not necessarily gain from traditional antenatal classes is the confidence and emotional insight which would usually be gained through informal communication with other women, and the practical experience of child care in extended families and community.

So if we are to collaborate with the women we are serving to facilitate health-promoting use of the web, what strategies, skills, programs, and systems do we need to implement?

24-h availability, anonymity, selectivity in responding, capacity for immediate and time-delayed reactions, unlimited volume of participants (including professionals), and exposure to an increased number of opinions, expertise and experience (Sharf, 1997; Haythornwaite et al., 1998; King and Moreggi, 1998).

The lack of non-verbal cues and potential for anonymity create a level playing field with regard to status (King and Moreggi, 1998). Because many demographic and physical differences are obscured, a sense of `groupness’ may evolve more readily.

Compared to traditional planned information dissemination phenomena, the Internet reflects a paradigm shift by offering interactivity and reciprocal influence, pointing toward transactional rather than one-way processes, and blending interpersonal and mass communication processes.


Simplicity and flexibility amidst the complexity of busy lives are some of the key benefits that technology brings the digital integrator. They live in an open book environment- just a few clicks away from any information, they connect in a borderless world- across countries and cultures, and they communicate in a post-literate community where texts and tweets are brief, and where visuals and videos get the most cut-through.

With online learning and flexible delivery, it is critical that the teaching and learning is designed to accommodate the needs of the women we are teaching.


How are we going to teach discerning and critical use of the web?

and last but not least, are we preparing and empowering midwives to be the conduit between the woman and the technology.

In other words, are we making information exchange and analysis into a natural streaming that includes both human and electronic format?

A high-tech conveyor in the rapid diffusion of information or health lessons.

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