In the United States, obstetric care is intervention intensive, resulting in 1 in 3 women undergoing cesarean surgery wherein mobility is treated as an intervention rather than supporting the natural physiologic process for optimal birth. Women who use upright positions and are mobile during labor have shorter labors, receive less intervention, report less severe pain, and describe more satisfaction with their childbirth experience than women in recumbent positions. This article is an updated evidence-based review of the "Lamaze International Care Practices That Promote Normal Birth, Care Practice #2: Freedom of Movement Throughout Labor," published in The Journal of Perinatal Education, 16(3), 2007.

Women who use upright positions and are mobile during labor have shorter labors, less intervention, fewer cesarean births, and report less severe pain, and describe more satisfaction with their childbirth experience than women in recumbent positions. The evidence for supporting physiologic childbearing for optimal birth fails to disrupt intervention intensive hospital practices that deny 60% of women mobility in labor despite calls by maternity care organizations to not restrict mobility for low risk women in spontaneous labor.

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The purpose of this article is to educate childbirth educators about environmental hazards and provide resources. Hazardous chemicals have been found in cord blood, placenta, meconium, and breastmilk samples. These chemicals include commonly known hazards such as lead, mercury, and environmental tobacco smoke, as well as some pesticides, solvents, products containing chlorine, and other chemicals referred to as ''persistent organic pollutants.'' The fetus is particularly vulnerable to environmental chemicals that can disrupt the developmental process at critical times during gestation. Childbirth educators are encouraged to inform themselves in order to inform childbearing families to take preventive action and explore alternative behaviors to reduce exposure to environmental hazards.

The Code of Ethics for Lamaze Certified Childbirth Educators outlines the ethical principles and standards that are derived from childbirth education's core values to assure quality and ethical practice.This article presents a summary of the history of ethics and medical ethics that informs a valueoriented decision-making process in childbirth education. The role of evidence in ethics is explored from the childbirth educator's viewpoint, and scenarios are used to reflect on situations that are examples of ethical distress. The conclusion is that the practice of ethics and ethical decision making includes regular reflection.