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Lamaze International Wants to Recognize Childbirth Education Leaders! Submit Your Nominations Now!

May 21st, 2015 by avatar

NominateDid you know that Lamaze International has several different awards that are given during the annual conference to recognize the contributions of deserving individuals to the field of childbirth education?  There are a total of four awards available, read about all four and consider if you have someone deserving of a nomination.

The Lamaze International Elisabeth Bing Award recognizes a Lamaze certified childbirth educator (LCCE)  who has “made outstanding contributions in the field of childbirth education.”  With Elisabeth’s passing late last week, after a long and productive life as the pioneer of childbirth educators, this award will be extra poignant in 2015.  Can you think of an educator who has achieved national or international recognition, embodies the principles of Lamaze International and has made positive contributions to the field of childbirth education? This year’s recipient will be joining prestigious past winners.  Please consider nominating a deserving educator so that they can be considered for this year’s award.

The Lamaze International Research Award is to honor the person or organization whose research has significantly contributed to the field of childbirth education and normal birth.  This award recognizes and encourages the need for ongoing research in the field of childbirth education to support the evidence-based content of Lamaze education and information.

The Lamaze International President’s Award is given at the discretion of the President to an individual or organization that embodies the spirit of the Lamaze mission and vision, and has made significant contributions to advancing safe and healthy pregnancy, birth and early parenting through evidence-based education and advocacy.

The Lamaze International Media Award is for Lamaze International to honor individuals or organizations that present normal, physiologic birth and/or Lamaze International in a positive light in the mass media. Can you think of a blogger or journalist who has worked hard to provide both consumers and professionals with accurate information on current best practice?  If so, consider nominating him or her to be considered for this award.

In order to nominate an individual or an organization for any of the above awards, please submit the nomination through our online form.  We ask you to also email a copy of the nominee’s CV/resume.  The Executive Committee will review the nominations in each category and select the award recipients.

The awards are presented at the annual conference, this year to be held September 17-21, 2015 in Las Vegas, Nevada.  Recipients are informed in advance so they may plan on being in attendance to receive their award. The deadline is June 1st, so don’t delay in submitting the names of deserving individuals.

Registration is now open for the conference, so take advantage of early registration savings by registering now.

 

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Elisabeth Bing, Mother of Lamaze, Remembered for Humanizing Childbirth

May 18th, 2015 by avatar

“I hope I have made women aware that they have choices, they can get to know their body and trust their body.”

 

Elisabeth Bing, 1914-2015, Co-Founder of Lamaze International

elisabethbingElisabeth Bing, known as the “mother of Lamaze” passed away on Friday, May 15th, 2015 in her home in New York City, NY a few weeks shy of her 101st  birthday.  Elisabeth, along with Marjorie Karmel, founded Lamaze International (then known as The American Society for Psychoprophylaxis in Obstetrics/Lamaze, or ASPO/Lamaze) 55 years ago.  Her legacy lives on, not only in the numerous books she authored, (Six Practical Lessons for an Easier Childbirth, her most well known book, first published in 1967) but in each one of us, especially Lamaze Certified Childbirth Educators, who have been helping women and families for decades to be “aware that they have choices, they can get to know their body and trust their body.”

There are many resources (see links below) written that document Elisabeth’s life, her journey from Germany, to England and then finally the USA, where she established a groundbreaking childbirth education program at Mt. Sinai Hospital in Manhattan.  I didn’t want to rewrite what has already been documented.  I encourage you to read them as they are both fascinating and factual, documenting the magnificent achievements of a life committed to improving birth for women and babies.

Teaching in Studio, 1978 © Lamaze

 

I wanted to share information about Elisabeth that has not already been shared. I never had the honor of meeting Elisabeth Bing, nor hearing her speak, so I wanted to ask some of the women and leaders of Lamaze International to share what Elisabeth was like from their own personal experiences with this icon of childbirth education. I wanted to know how she influenced their lives and their careers, and to learn more about who she was and what she was like.  I also wanted to share this information with you.  Please join me in, as these women share their thoughts and memories.

Judith Lothian, PhD, RN, LCCE, FACCE, Chairperson of the Lamaze Certification Council Governing Body, Associate Editor of the Journal of Perinatal Education and co-author of The Official Lamaze Guide: Giving Birth with Confidence

Mary Jo Podgurski, RNC, EdD, LCCE, FACCE, Past President of Lamaze International

Robin Elise Weiss, PhD, MPH, LCCE, FACCE, author and current Lamaze International President

Linda Harmon, MPH, Executive Director of Lamaze International

Sharon Muza: Do you remember the first time you met Elisabeth? Can you share the details of that meeting and your first impressions?

Linda Harmon: I met Elisabeth for the first time at the annual conference over twenty years ago. I was meeting the “mother of Lamaze”. She was gracious and warm, and took the time and interest to get to know me personally. It was always special to have a few moments with Elisabeth at the conference for many years after our first meeting all those years ago.

© Librado Romero/The New York Times

© Librado Romero/The New York Times

Robin Elise Weiss: The first time I actually saw Elisabeth in person was at a conference in Chicago. I was coming down the escalator and I looked over at the fountain and she caught my eye. She was sitting there with Sheila Kitzinger, and all I could think was “Wow what an amazing woman. And two great legends sitting together just as simple as could be, not even understanding the impact that they’ve had on my life.

Mary Jo Podgurski: I’d always admired Elisabeth from afar, hanging onto her every word during her talks and taking an occasional picture with her at a conference. I clearly recall when we first spent time together. I was elected to the Lamaze board in 1994. Elisabeth asked me to meet with her. She engaged me in conversation about so many things – my passion for working with teens, my personal belief system, my family, my values, my experiences with birthing women, my own births – I realized I was being vetted. She was wise, she listened to hear, and she was visionary. She became my mentor. In time we became close personal friends.

Judith Lothian: I met Elisabeth in 1973. She interviewed me in her apartment…where she died…for the NYC Lamaze teacher training program. I was nervous. She was gracious and kind. I took the seminar later that year. In that same apartment. A group of about 8. It was wonderful. Take aways? They were the foundation for my career and life as a childbirth educator. “The breathing works because women make it their own in labor” There was nothing rigid about the way she taught the principles of the then “psychoprophylaxis”. And then began a 20 year journey where Elisabeth mentored me…she had me take over the teacher training program in NYC and then said “It’s time you went on to DC to the national organization”. I never would have done either without her literally telling me to do it. A wonderful mentor.

Dr. Marshall Klauss, Elisabeth Bing, Linda Harmon (L-R)

Dr. Marshall Klauss, Elisabeth Bing, Linda Harmon (L-R) 1996 © Lamaze

SM: When did you last meet/see/communicate with Elisabeth? Can you share those details?

JL: We did a video for the 50th anniversary of Lamaze. I spent a day with Elisabeth in her apartment. We shared memories and had tea together and she watched the taping and participated. It was an incredible day.

REW: One of the last times that I saw Elizabeth she was actually swimming in the ocean at the Fort Lauderdale Lamaze conference. All I could think was I hope I have that much spunk when I’m 90 years old.

LH: I remember visiting Elisabeth in her New York apartment when Lamaze had the opportunity to do a quick Lamaze lesson on the Regis and Kelly show. I got the grand tour which included her ground floor studio where she taught Lamaze classes for many years.

MJP: The last time we saw one another was her 100th birthday celebration in her apartment in NYC – July 8th, 2014. We last spoke at Christmas, 2014, when I sent her my usual present, a dozen red roses. She never failed to call and thank me, and then she always sent a thank you note. I treasure her notes. When I was in New York I always went to see her. I remember walking into her apartment about two years ago. When I entered, she looked up and said, “It’s my friend Mary Jo!”

Elisabeth with son Peter © Lamaze

Elisabeth with son Peter © Lamaze

SM: How would you describe Elisabeth’s personality and character?

MJP: Independent. Wise. Fiercely loyal. Kind. Intellectual. Curious. Gentle. Visionary. Strong-willed.

REW: I saw her as an amazing combination of feisty and sweet. She wouldn’t take no for an answer but you always left with a positive impression. She always made me feel like I was the only person she was talking to or cared about in the moment.

JL: Strong. Wise. Generous and kind.

SM: How do you think Elisabeth would want to be remembered?

LH: For starting what was at the time a radical consumer movement to improve birth for women and their partners, a legacy that has stood the test of time and continues to be relevant and important 55 years later.

MJP: As an advocate for birth and for women. As a musician and writer. As a mother. As a friend

JL: As someone who helped women give birth easily and simply.

SM: Of all the contributions Elisabeth has made to childbirth, both here in the USA, and abroad, what do you think is her greatest legacy?

MJP: Elisabeth modeled independence, strength and true advocacy. She empowered women. We (CBEs) are her legacy.

JL: Beginning, really, the movement to change birth in the US. She was at the forefront and gave women with her “Six Practical Lessons” a way to do it. Simply and easily. It may seem rigid and simplistic today but it worked then.

REW: Her greatest legacy will be the fact that women now have choices that were once not even considered possible. Many women do not know her name, but have her to thank for the options that they now have in childbirth.

SM: What advice would Elisabeth give to today’s pregnant person about their upcoming labor and birth?

MJP: One of the last things I remember her saying at a conference presentation was ‘Now, let’s take on the insurance companies’. I think Elisabeth would empower a pregnant person by sharing knowledge, speaking truth to power, and modeling courage. I think she’d say that the woman’s body knew how to give birth.

REW: Know your options. Fight for what works for you and your family.

SM: Do you have a favorite quote or story that Elisabeth said or shared with you and others? What might that be?

JL: Elisabeth in the 1970s was on a radio show with Dr. Bradley. She refused to talk about which “method” of childbirth was better. She said “Anything that helps women have good births is what is important”. I was impressed that she was not pushing Lamaze… but acknowledging women. She was gracious and kind always.

MJP: Once when we were discussing her youth in Germany and her time in England during the Blitz, she told me how she reacted to the bombings. She said that, at first, she went to the shelters with other people when the air raid sirens wailed. In time, she decided not to go. She said she wouldn’t die huddled below ground, but would continue doing whatever she was doing when the raid began. Those words resonated with me then, and echo for me now.  I visited her about six weeks after 9/11. She was calm and unafraid. I spoke with her as soon after the attacks as I could; she expressed no anxiety. Elisabeth showed me how to live with courage and well.

SM: Any other comments that you would like to share?

MJP: I loved Elisabeth Bing as a mentor, a true educator, a strong woman of integrity, but most of all, as my dear friend. I will always love and remember her.

Dr. Mary Jo Podgurski and  Elisabeth Bing 2014 © Podgurski

Dr. Mary Jo Podgurski and Elisabeth Bing 2014 © Podgurski

JL: I found Lamaze (ASPO) because I wanted a natural birth. But then I found Elisabeth when I wanted to teach classes and help women have the wonderful birth experience that I had. I had the privilege of being trained by her…and, contrary to all that is said about early Lamaze, there was nothing rigid about the what she taught or the way she taught. What I learned from Elisabeth was the foundation for all that I have done as a childbirth educator and nursing educator, and as an advocate for safe, health birth.. I am eternally grateful.

_____________________

Elisabeth Bing had a vision that there was a better way to give birth and she made that vision a reality through her books, the organization she founded (Lamaze International), the thousands upon thousands of families she taught, the relationships she forged with medical professionals, and the men and women she mentored, guided, supported and taught who have gone on to become childbirth educators themselves, carrying on the mission and vision. Elisabeth once said, “I hope I have made women aware that they have choices, they can get to know their body and trust their body.” I think, upon reflection, that we can all agree that Elisabeth Bing was beyond successful in this goal, and millions of families are grateful for her work and her effort.  I join Lamaze International and the Lamaze leaders, past and present, Lamaze Board of Directors and Staff, Lamaze Certified Childbirth Educators, readers of this blog and families everywhere in sending our deepest sympathies to Elisabeth’s family on the loss of their mother and family member.  We will forever be deeply indebted to her legacy.

Do you have memories of meeting Elisabeth Bing? Hearing her speak? Reading her books?  Please take a moment to share your thoughts and what her work meant to you in our comments section.  Thank you.

Books authored by Elisabeth Bing (incomplete list)

 

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Great Line-up of Plenary Conference Speakers and President’s Desk Updates

May 14th, 2015 by avatar

lamaze icea conf 2015Today on Science & Sensibility – news you can use!  Plenary speakers have been announced for the upcoming conference and Robin Elise Weiss, Lamaze International’s Board President has a new series of informative videos called “From the President’s Desk” that you will want to check out.  Read on for information on both of these topics.

Lamaze/ICEA Joint Conference News

Lamaze International and the International Childbirth Education Association (ICEA) just announced their plenary (general session) speaker line up for the joint Lamaze/ICEA 2015 conference at Planet Hollywood, Las Vegas on September 17-20.  Four speakers will address the entire conference in general sessions and I am very much looking forward to listening to their presentations along with the many concurrent sessions that will be offered over the four days of the conference.

ICEA and Lamaze celebrated their 50th anniversaries together in 2010 in Milwaukee, WI with a well attended “mega-conference” that had great energy and educational offerings and I expect that this conference will be just as big and wonderful.  Bringing together two leaders in childbirth education to hold a joint conference means that all attendees will benefit in numerous ways.

The theme of the Las Vegas conference is “Raising the Stakes for Evidence Based Practices & Education in Childbirth” and I know that educators, doctors, midwives, doulas, L&D nurses, IBCLCs and others will come together and take advantage of this joint conference to network, learn, receive contact hours, and socialize with other professionals.  Maybe, even win a little at the blackjack tables or take in a great show.  Las Vegas is a great venue for this conference, offering a wide variety of locales, activities and nightlife to enjoy outside of conference  hours.

This year’s plenary speakers

camman head shot 2015William Camann, MD
Director of Obstetric Anesthesia, Brigham and Women’s Hospital,  Associate Professor of Anesthesia, Harvard Medical School

Presentation: What does the informed childbirth educator need to know about labor pain relief in 2015?

 

 

combellick head shot 2015Joan Combellick, MSN, MPH,CM
PhD Student, NYU College of Nursing
Midwife, Hudson River Healthcare

Presentation: Watchful Waiting Revisited: Birth Experience and the Neonatal Microbiome

 

 

Joseph head shot 2015Jennie Joseph, LM, CPM
Co-Founder and Executive Director
Commonsense Childbirth School of Midwifery

Presentation:The Perinatal Revolution: Reducing Disparities and Saving Lives through Perinatal Education and Support

 

 

mcallister head shot 2015Elan McAllister
Founder, Choices in Childbirth

Presentation: No Day But Today

 

 

 

 

Concurrent sessions

Watch the website for soon to be released information on concurrent speakers and their topics.  Concurrent sessions will fall into one of four categories:

  • Evidence-Based Teaching and Practice
  • Using Technology and Innovation to Reach Childbearing and Breastfeeding Women
  • New and Emerging Research in the Field of Childbearing and Breastfeeding
  • Challenges of the Maternal Child Professional

Preconference workshops

Additionally, there will be two preconference workshops available for a small additional fee.  These 4 hour workshops allow you to really immerse yourself in the topic and leave with concrete skills applicable to your work with childbearing families.

  • Movement in Birth (AM)
  • Social Media Smarts: Strategic Online Marketing for the Busy Childbirth Professional (PM)

Early bird registration is open until August 1, 2015, so registering now allows you to save money on the conference fees and make your travel and hotel plans now.  Look for interviews with the plenary speakers over the next few months on Science & Sensibility.

 From the President’s Desk

Board President Robin Elise Weiss, Ph.D, has recently made a series of short and useful videos for Lamaze International on several topics.  The video series is called “From the President’s Desk”. Released to date are several on cesareans;

Robin’s newest video discusses the recently released ACOG committee opinion “Clinical Guidelines and Standardization of Practice to Improve Outcomes“. This video helps both birth professionals and consumers to understand how pushing for the best evidence based care can result in both pregnant people and their babies having improved outcomes.  ACOG wants to be able to offer best practice to those receiving care from its members, and consumers can help by sharing their desire to receive care in line with recommended guidelines.

Head over to Lamaze International’s YouTube Channel to see all the offerings, share the relevant videos with your students and clients and subscribe to the channel so that you don’t miss any of the releases.

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New Research: Majority of Preeclampsia-Related Maternal Deaths Deemed Preventable

May 12th, 2015 by avatar

By Eleni Z. Tsigas

Preeclampsia Awareness Month 2015May is Preeclampsia Awareness Month and the journal Obstetrics and Gynecology highlighted some new research published by doctors and researchers at the California Maternal Quality Care Collaborative that demonstrated that the majority of preeclampsia-related deaths could have been prevented.  This is significant because preeclampsia is one of the top perinatal causes of death. Today on Science & Sensibility, Preeclampsia Foundation Executive Director Eleni Z. Tsigas provides an update on this new research and important facts that birth professionals should know.  As childbirth educators, along with teaching families about normal labor and birth, we have an obligation to share information about warning signs and potential complications.  While not as much “fun” as teaching how to cope with a contraction, it is equally important.  Have you checked out the information available at the Preeclampsia Foundation‘s website?  There is a great short video, class tear sheets and even information en español.  How do you teach about preeclampsia to the families that you work with?  Let us know in the comments section. – Sharon Muza, Science & Sensibility Community Manager

Research published in the April 2015 issue of Obstetrics & Gynecology shows that 60 percent of preeclampsia-related maternal deaths were deemed preventable. This large study – Pregnancy-Related Mortality in California: Causes, Characteristics, and Improvement Opportunities – analyzed U.S. pregnancy-related mortality administrative reports and medical records for each maternal death to identify the causes and contributing factors, and improve public health and clinical practices.

Over the last 20 years, a previous decline in maternal deaths has reversed and is cause for concern. The 2009 U.S. pregnancy-related mortality rate was 17.8 deaths per 100,000 live births, up from 7.7 per 100,000 in 1997 and above that of other high-resource countries.

One of every eight U.S. births occurs in California, resulting in more than 500,000 annual deliveries with extensive racial and ethnic diversity. With California’s large population-based sample, this study provides a unique opportunity to compare major causes of pregnancy-related mortality and identify improvement opportunities.

Preeclampsia-related maternal death deemed most preventable

Among the 207 pregnancy-related deaths from 2002 to 2005 studied in California, preeclampsia or eclampsia were identified as one of the five leading causes. The others were cardiovascular disease, hemorrhage, venous thromboembolism, and amniotic fluid embolism.

Of the five leading causes of death, preeclampsia was deemed one of the most preventable – preeclampsia-related deaths had a good-to-strong chance of preventability, estimated at 60%.

Healthcare provider factors were the most common type of contributor, especially delayed response to clinical warning signs followed by ineffective care.

Patients play important role in preventing preeclampsia-related deaths 

The leading patient factors among preeclampsia deaths were delays in seeking care (42%), presumed lack of knowledge regarding the severity of a symptom or condition (39%), and underlying medical condition (39%).

Preeclampsia deaths were most common among foreign-born Hispanic and African American women and associated with early gestational age, consistent with studies demonstrating the increased severity of early-onset preeclampsia.

These findings illustrate the need for public health interventions aimed at helping all women understand and recognize their risks and attain optimal pre-pregnancy health and weight.

It’s worth noting that since the study period, patient awareness has improved, led by several Preeclampsia Foundation education initiatives – currently preeclampsia awareness among pregnant women is 83%, according to a survey conducted last year by BabyCenter®.

The findings also underscore the need for focused approaches to improve care such as hospital-based safety bundles as well as comprehensive programs for patient education, communication, and teamwork development. Read the full report here.

Maternal health improvement initiatives underway 

As these Pregnancy-Related Mortality research findings are announced, several states have already moved forward with maternal health improvement initiatives. Recently the California Maternal Quality Care Collaborative (CMQCC), Hospital Corporation of America, and the American College of Obstetricians and Gynecologists released guidelines and quality improvement toolkits with standardized approaches to recognize and treat severe hypertension, and to increase awareness of atypical clinical presentations and patient education.

CMQCC’s Preeclampsia Toolkit incorporated the Preeclampsia Foundation’s Illustrated Symptoms Tear Pad that effectively informs women who are pregnant or recently gave birth about preeclampsia, which can strike up to six weeks after delivery. Developed by the Preeclampsia Foundation and researchers at Northwestern University Feinberg School of Medicine, the tear pad uses illustrations to describe the symptoms of preeclampsia so they are easily understandable, especially for those with poor health literacy. This toolkit is freely available online and has been downloaded by over 5,100 persons in the United States and more than 60 other countries. It is also being implemented in more than 150 California hospitals as part of the California Partnership for Maternal Safety.

In the year since implementing a Severe Maternal Morbidity Pre- and Post-Toolkit, CMQCC has noted a 34% reduction in maternal adverse outcomes. After implementing Pre- and Post-Hypertension Bundles, the rate of eclampsia has decreased by 31%.

New York joins California in distributing the tear pad throughout the state – as part of a statewide Maternal Preeclampsia Initiative, the New York State Perinatal Quality Collaborative, an initiative of the New York State Department of Health and the New York State Partnership for Patients – has adopted this patient education tool, making it available to all New York birthing facilities.

The Preeclampsia Foundation is proud to play a role in reversing the rate of maternal mortality and severe morbidity; it’s a team effort that requires the combined efforts of public health, clinical and hospital leaders and their institutions, and professional and consumer organizations.

References

Main, E. K., McCain, C. L., Morton, C. H., Holtby, S., & Lawton, E. S. (2015). Pregnancy-related mortality in California: causes, characteristics, and improvement opportunities. Obstetrics & Gynecology, 125(4), 938-947.

About Eleni Z. Tsigas

G8FK7644Eleni Z. Tsigas is the Executive Director of the Preeclampsia Foundation. Prior to this position, she served in a variety of volunteer capacities for the organization, including six years on the Board of Directors, two as its chairman. Working with dedicated volunteers, board members and professional staff, Eleni has helped lead the Foundation to its current position as a sustainable, mission-driven, results-oriented organization.

As a preeclampsia survivor herself, Eleni is a relentless champion for the improvement of patient and provider education and practices, for the catalytic role that patients can have to advance the science and status of maternal-infant health, and for the progress that can be realized by building global partnerships to improve patient outcomes.

She has served as a technical advisor to the World Health Organization (WHO) and participated in the Hypertension in Pregnancy Task Force created by the American College of Obstetricians and Gynecologists to develop the national guidelines introduced in 2013, as well as a similar task force for the California Maternal Quality Care Collaborative (CMQCC). Eleni also serves on the National Partnership for Maternal Safety initiative, the Patient Advisory Board of IMPROvED (IMproved PRegnancy Outcomes via Early Detection), Ireland, and the Technical Advisory Group and Knowledge Translation Committee for PRE-EMPT (funded by the Bill & Melinda Gates Foundation). Eleni is frequently engaged as an expert representing the consumer perspective on preeclampsia at national and international meetings, and has been honored to deliver keynote addresses for several professional healthcare providers’ societies.

Eleni has collaborated in numerous research studies, has authored invited chapters and papers in peer-reviewed journals, and is the Principal Investigator for The Preeclampsia Registry.

A veteran of public relations, she has secured media coverage about preeclampsia in national consumer magazines, as well as newspapers, radio and online. Eleni previously spent 8 years executing and managing strategic communications and public relations for technology and biotech companies with Waggener Edstrom Worldwide and for 6 years prior in the television industry.

She is married, and has had two of her three pregnancies seriously impacted by preeclampsia. 

 

Childbirth Education, Guest Posts, Maternal Quality Improvement, Maternity Care, Pre-eclampsia, Research , , , ,

Book Review: Birth Ambassadors; Doulas and the Re-Emergence of Woman-Supported Birth in America.

May 7th, 2015 by avatar

By Kim James, BA, BDT(DONA), CD(PALS), ICCE, LCCE

May is International Doula Month and Lamaze International recognizes the importance of labor support. (Note – there are both birth and postpartum doulas who work with families during the childbearing year. We are grateful for the work that they both do.)  In fact, our third Healthy Birth Practice specifically addresses doulas and support people as an effective component of safe and healthy birth. The American College of Obstetricians and Gynecologists (ACOG) in their 2014 Safe Prevention of the Primary Cesarean Obstetric Care Consensus Statement stated “published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula.”  Childbirth educators and health care providers have ample opportunity to inform parents about the benefits of a doula when they are meeting with families and patients.  

In mid-2014, sociologist Christine Morton, Ph.D. with Elayne G. Clift, MA, wrote a book, Birth Ambassadors: Doulas and the Re-Emergence of Woman-Supported Birth in America examining doulas from both an historical perspective as well as an assessment of the role of the doula in current American society . Kim James, LCCE and certified DONA birth doula, reviews this book and shares her perspective and take-aways with readers of this blog.

This book would make a great read for a book club book for birth professionals, and Kim generously shares some discussion questions at the end of today’s post to facilitate your discussion, should you wish to participate.  Alternately, if you have read the book, please feel free to respond in our comments section. 

Science & Sensibility and Lamaze International want to thank all the doulas who work tirelessly to support families as they birth their babies and transition to parenthood. Happy International Doula Month. – Sharon Muza, Science & Sensibility Community Manager. 

idm15 lamazeBirth Ambassadors: Doulas and the Re-Emergence of Woman-Supported Birth in America, written by Christine Morton, Ph.D. with Elayne G. Clift, MAis a thorough and compelling documentary of the history of doula support, the current dilemmas and issues facing the doula occupation, what drives doulas to pursue this work and how the work of doula support might fit into the future as the United States strains to find better ways of providing quality improvements in maternity care. For doula trainers and doulas looking to pursue this work in a professional manner, Birth Ambassadors is critical, mandatory reading. (For trainers and doulas interested in how to use this book to critically assess your work, please see the discussion questions below this article).

But what about for childbirth educators? What in it for them?

While the history is fascinating, it’s the critical sociological analysis of the current dilemmas and issues facing the doula occupation that childbirth educators’ need to thoroughly understand, especially Lamaze certified childbirth educators.

Lamaze International’s third Healthy Care Practice, ‘Bring a Loved One, Friend or Doula for Continuous Support’, outlines why continuous support is important and how a doula performs their work:

  • Continuous support can help alleviate fear and worry.
  • A doula’s intuitive sense and training mean emotional and physical needs are met with timely, individualized care.
  • Greater emotional and physical comfort may encourage the most efficient and healthy labor progress.

While most childbirth educators are aware of the intended benefits of doula care, not all are aware of the dilemmas doulas face in performing their work and the institutional and cultural issues that prevent doulas from having the greatest beneficial impact. Lamaze certified childbirth educators must have a firm understanding of these dilemmas so as not to ‘over-promise’ what the third Lamaze Healthy Care Practice is intended to deliver.

I want to highlight three dilemmas facing doulas that childbirth educators should be aware of and what they can do to educate parents who want doula-supported birth experiences:

Kim James' well read Birth  Ambassadors

Kim James’ well read Birth Ambassadors

First dilemma

The ecological fallacy of applying aggregate results of research that show doula efficacy to an individual family’s outcome. The cultural and institutional context of most US hospital births limit the doula’s efficacy, often by prohibiting truly continuous support and refusing to recognize a doula’s unique scope of practice. Childbirth educators should lead discussions with parents about what hospitals and which care providers in their areas are most and least supportive of doula care. Childbirth educators are instrumental in helping parents understand the questions they can ask during hospital tours and prenatal visits to find out if their chosen place of birth and attendant understand and support doulas attending families at births.

Second dilemma

The frequent contradiction between a doula’s personal values (often a deep belief in the optimality of the midwifery model of care, natural, drug-free childbirth or specific parenting practices) and her obligation to provide unconditional support for parents’ birth and parenting choices. Childbirth educators must help parents clarify their values around birth and parenting so that parents can find the support people who suit them best. Not every doula will be the best support for every parent.

Third dilemma

No occupation-wide standard for training or certification. The competing tensions within doula organizations between increased professionalization and maintaining low barriers to entry for all people to become doulas remain unresolved. While the majority of doulas are well-trained through recognized, long-standing organizations, some will only have received light, if any, training possibly through correspondence and online courses. Not every doula’s skill set is the same. Not every doula will practice within a scope of practice that is evidence based. Not every doula will pledge to follow a recognized code of ethics backed by an organization with an active grievance policy. Childbirth educators who make referrals to families asking for doulas should always make referrals to doulas who are well-trained, consistently receive excellent feedback from the families they serve and most importantly practice in a manner that is consistent with the evidence based third Lamaze Healthy Care Practice.

As a current Lamaze certified childbirth educator and professionally-working certified doula, I found my own experiences reflected in this book. While at times uncomfortable to confront the dilemmas and issues our occupation faces, Birth Ambassadors is well worth reading for the history and reflections for the future. It will give childbirth educators who are not currently practicing doulas good data on what the real impact of doula support means for the families that hire them.

Book club discussion questions

When Birth Ambassadors was newly released, I hosted a book club-style discussion group with several local doulas to discuss this book’s implications for our current and future work. Here are the big questions that came up for our group representing doulas who were well-established in their practices, those who were just starting out and both certified and non-certified doulas.

  • When is your personal bias stronger than your ability to offer unconditional support? (Reference: page 195).
  • Analyze this: “Doulas advocate evidence-based care for physiologic birth, yet are not trained clinically to recognize or treat women when their pregnancies and labors become non-normal”. (Reference: page 37).
  • The original purpose of the first doula organizations was to provide moral support for each other. What do we need from our organizations now? (Reference: page 90)
  • Do we have the training to be professionally non-judgmental? (Reference: page 196).
  • Doula neutrality –When do you abandon it? How do you maintain it? (Reference: page 261).
  • What are the current debates around our standard of practice and code of ethics? (Reference: page 81).
  • Outcome-based care vs emotional companionship: What are you drawn to in this work? (Reference: page 260)
  • Are you comfortable with the “outsider-within” role? Does attract or repel you? (Reference: page 36)

How do you talk about doulas in your childbirth classes?  In your midwifery or obstetrical practice?  Have you read Birth Ambassadors?  What were your big take-aways?  Have you shared Lamaze International’s “Who Says Three’s a Crowd?” infographic with the families you work with?

Note: Christine Morton is a member of Lamaze International’s Board of Directors.

About Kim James 

Kim James HeadshotKim James BA, BDT(DONA), CD(PALS), ICCE, LCCE, is an ICEA and Lamaze certified childbirth educator teaching at Parent Trust for Washington Children/Great Starts where she sits on the Education Committee. She owns and operates www.DoulaMatch.net and is a DONA International and PALS Doulas certified birth doula as well as a DONA-approved birth doula trainer working at the Simkin Center/Bastyr University. Kim also volunteers her time on the Lamaze International membership committee and serves as Washington State DONA SPAR. Her daughters are 9 and 16 years old.  Kim and her family live in Seattle, Washington.

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