FB Pixel

Pregnancy, Birth, & Postpartum Physiology Module

Childbirth International’s certification programs (Birth Doula, Postpartum Doula, Childbirth Educator, and Lactation Counselor) include four modules: Communication Skills; Physiology; Professional Skills; and Business of Birth. Each module has a number of units or topics relevant to your work as a birth and lactation professional. Within a unit, you’ll read the course materials, complete self-guided reflective and critical thinking activities, and view external readings and videos. There may also be additional discussion forums, assignments, quick quizzes, and tests, which are required if you choose to complete the certification requirements.

The Pregnancy, Birth, & Postpartum Physiology module is included in both the programs to become a certified birth doula and a certified childbirth educator. If you are studying both of these courses, this module is only completed once and does not need to be repeated for the other course.

Topics in Pregnancy, Birth, & Postpartum Physiology

Understanding the normal physiology of pregnancy, labor, birth and the early postpartum period provides you with the knowledge you’ll need for working with pregnant clients. A strong understanding of physiology is an essential part of your birth doula training. This module will explore the physiology of pregnancy, labor and birth, the early postpartum period, the physiology of the newborn, and the psychological health of the new parent. You will also be looking at relationships, health and nutrition, vaginal birth after cesarean (VBAC), and an introduction to lactation. The topics covered in the pregnancy, birth, & postpartum physiology module include:

An explanation for each unit within the Pregnancy, Birth, & Postpartum Physiology module can be found below, together with a table outlining the competencies you will build in each unit.

Physiology in Pregnancy

Having a sound understanding of the physiological processes that surround pregnancy and childbirth is imperative for both childbirth educators and birth doulas. It will enable you to better comprehend when abnormal events occur and develop your skills in assisting clients to care for themselves during the childbearing year. During this unit, you’ll cover the physiology of pregnancy, developing a thorough understanding of the growth of the fetus (from conception through to term), reproductive anatomy, and the changes that occur during pregnancy.

Certification activities in this unit

  • 22 multiple-choice questions in an open-book exam
Essential KnowledgeContextual UnderstandingAttitudes and Behaviors
  • Identify features of the female pelvis
  • Describe normal variations of the placenta
  • Explain the physiology of pregnancy
  • Describe the process of human reproduction
  • Describe physiological and emotional changes during pregnancy
  • Describe normal fetal development
  • Explain the role of the pelvic floor
  • Explain the role of the placenta in pregnancy
  • Compare and contrast placental insertion variations and evaluate the impact of interventions related to placental insertion variations
  • Recognize the impact that fetal position has on fetal skull diameters
  • Translate physiological explanations into language easily understood by a layperson
  • Use reflective practice skills to consider the perspectives of pregnant clients and how these impact your practice

Return to top of page

Physiology in Labor & Birth

Understanding the physiology of labor and birth is fundamental as part of the knowledge base of childbirth educators and birth doulas. Recognizing the stages of labor, responses to labor, and the different patterns that labor can take all help you to communicate and support your clients effectively. During this unit, you’ll cover the physiology of labor and birth. You’ll develop a thorough understanding of the processes and mechanisms of labor.

Certification activities in this unit

  • 17 multiple-choice questions in an open-book exam
Essential KnowledgeContextual UnderstandingAttitudes and Behaviors
  • Describe the mechanisms of labor starting
  • Explain the stages of labor
  • Explain the process of labor in relation to the baby
  • Identify physiological labor patterns
  • Describe indications of labor progress
  • Consider indications of each stage of labor that you have personally observed
  • Differentiate between physiological and pathological labor and birth
  • Compare and contrast active and expectant management
  • Translate complex physiological explanations into language that is easily understood by a layperson
  • Reflect on your role as an advocate for change

Return to top of page

Physiology of the New Parent

During this unit, you’ll explore the normal physiology of the early postpartum period – the first few weeks after the birth of a baby. You’ll consider the events that are normal for this period, the physical recovery, and the emotional changes that typically occur. You’ll also look at recovery after a cesarean birth, and feeding an infant after a cesarean.

Essential KnowledgeContextual UnderstandingAttitudes and Behaviors
  • Explain the physiology of the early postpartum period
  • Describe the variations of lochia
  • Identify the risk factors for infection of the surgical site following a cesarean
  • Order the sequence of events in the postpartum period
  • Explore the evidence on perineal care
  • Translate complex physiological explanations into language that is easily understood by a layperson
  • Build up a library of resources to support clients in the postpartum period

Return to top of page

Psychological Changes in the Postpartum Period

During the early postpartum period, new parents may go through a variety of emotional changes. This is partly due to fluctuations in their hormone levels, together with the enormous lifestyle changes and responsibility that having a new baby brings. A newborn baby makes enormous demands on the energy, time, and emotions of a new parent. This can at times seem overwhelming, particularly when an individual gives birth for the first time. The sudden realization that they are responsible for this tiny person 24 hours a day can be daunting. Despite parenting classes, no amount of preparation seems to prepare parents for the reality of caring for a new baby. This unit will explore the normal psychological changes that take place in the postpartum period, together with postpartum mood and anxiety disorders.

Essential KnowledgeContextual UnderstandingAttitudes and Behaviors
  • List five factors that increase the risk of a perinatal mood and anxiety disorder
  • Identify five symptoms of postpartum depression
  • Identify four resources that can support a family where an individual is experiencing a perinatal mood and anxiety disorder
  • Compare and contrast postpartum mood and anxiety disorders
  • Reflect on how to address postpartum mood and anxiety disorders with clients
  • Consider the steps a birth-lactation professional can take to minimize the risk of a perinatal mood and anxiety disorder
  • Reflect on own needs for support and guidance when supporting a client with a perinatal mood and anxiety disorder
  • Provide clients experiencing a perinatal mood and anxiety disorder with resources for support
  • Recognize own limitations in supporting a client with a perinatal mood and anxiety disorder
  • Seek support from peers when working with a client with a perinatal mood and anxiety disorder

Return to top of page

Adaptation of the Newborn

In this unit, you’ll explore the normal physiology and health of the baby in the early postpartum period. Just as it is important to understand the parent’s physiological experience in the postpartum period, it is also important to understand the physiological adaptations the baby makes after birth, what physical patterns are normal in a newborn, and what problems can occur. When a baby is born a number of physiological changes take place that is nothing short of miraculous. The baby, who has completely relied on its parent until the birth for oxygen, nutrition, and protection must be able to function separately within minutes of being born. You’ll look at the main physiological changes that occur in the minutes after birth. A grounding in this information will help you provide information so parents can make informed decisions, and feel more confident about their early parenting experiences. 

Certification activities in this unit

  • 13 multiple-choice questions on postpartum physiology
Essential KnowledgeContextual UnderstandingAttitudes and Behaviors
  • Identify key physiological changes in the newborn
  • Describe the symptoms of physiological jaundice
  • Describe how bilirubin is processed by the newborn body after birth and how it impacts jaundice
  • Compare and contrast respiration in the fetus and the neonate
  • Translate complex physiological explanations into language that is easily understood by a layperson
  • Promote evidence-informed care for the treatment and management of conditions in the newborn

Return to top of page

Health & Nutrition

While the specific links between diet and pregnancy outcome are not always simple and clear, many of the complications that can arise during pregnancy, such as diabetes, are made worse by poor nutrition and lack of exercise. Research shows benefits to adopting a healthy diet early in pregnancy although it is more likely that these health improvements result from people having access to healthier foods and better living conditions. We use the term “diet” to mean the range of foods eaten in a day or a week, not “diet” in the sense of a structured weight-loss plan. A person’s activity level also ties into their physical and emotional health. In this unit, you’ll look at what is “healthy eating,” the nutrients that are the building blocks of nutrition, how diet affects the health of the parent and baby, and what happens when the diet or level of exercise may be contributing to ill health. You’ll also look at the benefits of exercise and tips on getting active. An understanding of these principles is helpful for you as a birth and lactation professional so you can support clients who may lack basic information about healthy eating and its role in well-being, or may feel overwhelmed at the idea of making changes in their diet or level of activity.

Essential KnowledgeContextual UnderstandingAttitudes and Behaviors
  • List the basic elements of healthy eating and describe their functionsDescribe two functions of each nutrientList five food sources for each nutrientIdentify the risks of a poor dietExplain how nutrition affects pregnancy, fetal growth, and maternal wellness, and discuss nutritional guidelines for pregnancyExplain how nutrition affects and supports breastfeeding, and discuss nutritional guidelines for lactationExplain how diet plays a role in several illnesses and complaints an individual may experience during pregnancy and in the postpartum periodDescribe the basic principles of how exercise affects health and well-being during pregnancy and in the postpartum period
  • Examine the basic principles of how what the parent eats affects their health and the health of the baby during pregnancy and in the postpartum period
  • Outline strategies people can use to improve their diet
  • Evaluate the benefits and disadvantages of measuring maternal weight gain and fetal growth during pregnancy
  • Document and analyze own diet and identify improvements

Return to top of page

Diet-Related Issues

Many illnesses and common complaints in pregnancy and the postpartum period may be caused or affected by diet. In this unit, you’ll review some of the most common diet-related health problems and analyze the special dietary needs of specific groups.

Certification activities in this unit

  • 15 multiple-choice questions on health, nutrition, and diet-related issues
Essential KnowledgeContextual UnderstandingAttitudes and Behaviors
  • Explain how the glucose tolerance test is carried out
  • List the options for preventing pre-eclampsia
  • Name four types of anemia
  • List special dietary needs for specific groups of people such as adolescents, people on a vegetarian diet, or people with diabetes
  • Review the controversy over-treating low hemoglobin levels with iron supplements and identify the physiological reasons for hemoglobin levels dropping in pregnancy
  • Evaluate alternative foods that could be used to ensure adequate nutrition for people who have food intolerances
  • Recognize the links between diet and health in pregnancy
  • Provide diet-related information to clients that is appropriate for the audience

Return to top of page

Pain in Labor

For many, the fear of pain during labor is their major concern throughout their pregnancy. Understanding why pain is experienced during labor, the options available for managing the pain, and the benefits and disadvantages of each option, is important if you are to help your clients be truly informed during labor. During this unit, you’ll explore the concept of pain itself and develop a deeper understanding of the options available. You’ll learn about the pharmacology of each pain relief method available in the hospital environment and how they provide pain relief.

Certification activities in this unit

  • 11 multiple-choice questions on pain in labor
Essential KnowledgeContextual UnderstandingAttitudes and Behaviors
  • Describe the physiology of labor pain
  • Explain the role of stress hormones
  • Describe several pain theories
  • Describe different techniques for assessing pain
  • Identify non-pharmacological methods for relieving pain
  • Compare and contrast the benefits and disadvantages of different pain relief options
  • Evaluate pain relief options available within the local community
  • Explore the pharmacological effect on the body of pharmaceutical drugs commonly used during labor
  • Develop a visualization that would be suitable for someone to use for relaxation during stressful situations, labor, or the postpartum period

Return to top of page

Interventions, Policies, & Procedures

During this unit, you’ll consider the common interventions that people experience during labor, together with the policies, procedures, and standard routines found in healthcare settings that can impact your clients. You’ll explore the reasons for routine procedures and the potential consequences of these, and discuss alternatives to routine procedures.

Certification activities in this unit

  • 20 multiple-choice questions on labor interventions
Essential KnowledgeContextual UnderstandingAttitudes and Behaviors
  • Explain the components of active management as they were originally defined
  • Describe the concept of “cascade of intervention”
  • List three medical reasons for induction of labor
  • Name four oxytocic drugs
  • List four non-pharmaceutical options for induction of labor
  • List five reasons a person might choose an actively managed third stage, and five reasons why they might choose an expectantly managed third stage
  • Discuss the pros and cons of active and expectant management and situations where one might be more appropriate than the other
  • Identify the potential consequences of active management
  • Evaluate how a Bishop’s Score could be beneficial for someone considering induction of labor
  • Examine different methods for avoiding damage to the perineum and minimizing the need for an episiotomy
  • Approximate the stage of labor a person is in based on alternative ways of assessing progress
  • Develop evidence-based resources that would help a client to make an informed choice about interventions in pregnancy and labor

Return to top of page

Cesarean & Vaginal Birth After Cesarean (VBAC)

Cesarean rates continue to increase in most countries around the world despite the risks to both parent and baby. During this unit, you’ll consider the reasons for the increasing cesarean rate and possible indications for cesarean birth. You’ll also explore the consequences of cesarean and the alternatives available. You will develop a deeper understanding of vaginal birth after cesarean (VBAC), the true risks and benefits, and under what circumstances a VBAC may not be available.

Certification activities in this unit

  • 10 multiple-choice questions on labor interventions
Essential KnowledgeContextual UnderstandingAttitudes and Behaviors
  • List the indications for a cesarean
  • Discuss the differences between planned and unplanned cesareans
  • Explain the procedure of a cesarean
  • Describe the typical recovery process after a cesarean
  • Identify the risks of VBAC
  • List the benefits and disadvantages of VBAC
  • Explain the contraindications for VBAC
  • Compare and contrast the elements of a family-centered cesarean and a “typical” cesarean
  • Provide non-judgmental support for individuals planning a VBAC
  • Provide non-judgmental support for individuals planning a cesarean

Return to top of page

Introduction to Lactation

As a provider of childbirth classes or postpartum support, you’ll often be called upon to provide information on feeding a baby human milk. You may also be asked to answer questions or provide support to people who are experiencing problems with lactation. During this introduction to lactation unit, you’ll look at how the human body makes milk and how the process of lactation works. You’ll also explore the more common problems that clients might experience, understand what causes these problems, and consider pumping and weaning.

Essential KnowledgeContextual UnderstandingAttitudes and Behaviors
  • Identify five key anatomical features of the adult breast/chest
  • Match the anatomical features of an infant related to breast/chestfeeding
  • Describe the milk ejection reflex (let-down)
  • Explain how human milk changes over time
  • List ten benefits of exclusively feeding an infant human milk
  • Identify four different positions for breast/chestfeeding
  • List the risks and benefits of using pacifiers
  • List the symptoms and solutions for a range of basic lactation problems
  • List five social and cultural influences on individuals when considering breast/chestfeeding
  • List five ways that a birth and lactation professional can promote breast/chestfeeding
  • Examine the anatomical features of the infant and parent that affect human milk productionExplore the impact of suckling and suckling frequency on supply and demandExplore the evidence on the benefits of lactation and feeding a baby human milkExplore how cesarean birth can impact lactationConsider the factors that influence a client choosing to use pacifiersConsider the different ways to determine an infant’s intake of human milkDiscuss the motivational factors that determine whether a parent intends to breast/chestfeedReflect on personal feelings about promoting breast/chestfeeding
  • Provide information on the anatomy of lactation suitable for expectant or new parents
  • Provide resources to clients that explain the concept of supply and demand during lactation
  • Provide non-judgmental support to clients in their infant feeding choices
  • Provide documentation on the benefits of exclusive breast/chestfeeding
  • Provide resources on establishing lactation after a cesarean birth
  • Provide information to clients on the evidence relating to the use of pacifiers
  • Support clients in resolving basic lactation problems
  • Recognize that breast/chestfeeding is a significant life event for many families
  • Promote breast/chestfeeding and human milk as the optimal food for infants in the first six months

Certification activities in this unit

  • 2 case studies on physiology in pregnancy, birth, & the early postpartum period

Return to top of page

Read About Our Other Modules