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BABE Series: Postpartum Survival Kit – Helping Families Be Ready for Life with a Newborn

May 26th, 2015 by avatar

By Cara Terreri, LCCE

PSK BABEMay’s Brilliant Activities for Birth Educators (BABE) idea is all about the postpartum period.  Lots of families don’t realize that good childbirth classes not only prepare families for the labor and birth but can be a wealth of information about the first weeks with a new baby.  Today on Science & Sensibility, Cara Terreri, LCCE shares her classroom activity to help families get ready for what happens after the birth – when they bring that new little one home. – Sharon Muza, Science & Sensibility Community Manager 

Introduction

The postpartum period is an important component of childbirth education. As we know, preparation for the birth of a child isn’t enough. And unfortunately in our culture, postpartum needs aren’t given a lot of attention, which means that parents often feel unprepared, confused, and frustrated during the early days and weeks after baby comes home.

For my childbirth classes, I developed a fun and interactive activity to introduce and discuss the many topics related to postpartum. The exercise can be a stand-alone activity (in a refresher childbirth class) or used as an opener to more in-depth activities and lessons on postpartum in an entire series. My inspiration for creating the “Postpartum Survival Kit” was the wonderfully humorous “Postpartum Robe,” a trademark teaching tool from Teri Shilling, MS, CD(DONA), IBCLC, LCCE, Passion for Birth founder and Lamaze educator, as well as Lamaze Childbirth Educator Seminar trainer.

The Postpartum Survival Kit (PSK) consists of a large plastic container with lid (mine also includes a handle, which helps for easy transport), and includes 23 items representing different issues or experiences a family may encounter during the postpartum period. The items represent everything from the physical recovery after birth (peri bottle, thick menstrual pad, and hemorrhoid cream) to emotional issues, like the importance of finding “me time” and postpartum mood disorders.

How It’s Used

In my classes, after introducing the topic of the postpartum period, I bring out the PSK, pass it around, and instruct families to take out 2-3 items (depending on the number of students in class). I then introduce the PSK and talk about how the different items represent typical encounters and issues during the postpartum. We then go around the room and each couple is asked to share the items they pulled and offer an explanation of their significance. Some items are more obvious, like the sleep mask for the importance of getting sleep when you can; some elicit giggles and awkward moments, like the KY jelly which represents the possible need for vaginal lubrication during intercourse if the parent is breastfeeding; and some items are confusing, like the mini manicure kit (taking “me time”) and the red golf ball (size of postpartum clots, what’s normal and what’s not).

photo 2When students share their items, I jump in when they (or the other students) cannot accurately describe the item’s meaning. I also open the floor for discussion with open-ended questions like “How would you cope?” and “What kind of support would you need if this should happen to you?” and “Who could you call on for help?” Depending on the size of your class, this exercise can take up a good amount of time, so be sure to plan appropriately and be prepared to reel in side discussions should it get off course.

Takeaways

Parents in my classes really enjoy this exercise. I get a lot of laughs, bewildered looks, and “lightbulb” moments. It’s always interesting to see how often the non-birth parent accurately describe the significance of items in this exercise – there have been many moments where the pregnant person is stumped, but the partner knows. In these instances, the exercise provides reassurance to both parents that the knowledge on what to expect during postpartum is intuitive. Additionally, I have found that this tangible exercise helps reinforce learning and memory when we talk more in depth about postpartum issues later in the class.

Modifications

The PSK exercise can be modified in several ways. I’ve used it in coordination with a worksheet, which could also be turned into a competition between families. If using in a private class, you can have each family member take turns with each new item. You could also use the exercise as an interactive teach-back. Ask each family to take out 2-3 items, learn about their significance (offer assistance if they are completely stumped), and then return to the next class and teach the other students.

The PSK also could be replicated for use in teaching the stages of labor and breastfeeding. Create a similar, smaller kit for each stage of labor and/or breastfeeding and begin the segment with the kit. For example, a Transition Kit may include a focal point, washcloth, water bottle, and mini bullhorn (to signify the “take charge” routine). 

Contents & Creating Your Own

The fun part about creating a PSK is making it uniquely your own! Some of the items will naturally be the same (lochia pad, hospital underwear, peri bottle, breastfeeding pads, for example), but others are limited only by your creativity! Consider the ways in which you can demonstrate postpartum mood disorders, changing emotions, dividing up hours in the day, eating nutritious food, sleep, etc. Items included in my Postpartum Survival Kit are:

  • Water bottle – keeping hydrated
  • Hospital underwear and pad – postpartum bleeding
  • Peri bottle, Dermaplast, and ice pack – perineal healing
  • Elastic abdominal brace – cesarean healing and core strengthening
  • Plate with balanced meal – postpartum nutrition
  • Ibuprofen – normal aches and pains
  • Hemorrhoid cream – a not uncommon postpartum issue
  • Stool softener – this is an important concern for many!
  • KY Jelly – lubrication issues
  • Condoms – postpartum fertility/birth control
  • Eye mask – getting sleep
  • Small red balloon paired with giant red balloon – involution, postpartum tummy
  • Hand mirror with puzzled/confused face – postpartum mood disorders (“I don’t recognize myself”)
  • Laminated speech bubble with “helpful” advice – dealing with influx of family/friend advice
  • Cloth breastfeeding pads – leaking nipples
  • Stuffed heart toy with wide open arms – finding and accepting support
  • Do not disturb door hanger – limiting visitors is ok; family time is important
  • Small baby doll with a heart and question mark on her tummy – conflicting emotions a baby often brings
  • Encouragement flags – encourage and praise your partner
  • Manicure kit – making time for yourself
  • Pill box modified to read “house, partner, work, baby care, errands, etc.” and filled with 24 beads, divvied up into the different compartments – how will you divide your time

 What else might you add to your customized Postpartum Survival Kit? There are many ways to teach about adapting to and surviving the postpartum weeks.  How do you teach about the postpartum period in your childbirth classes?  What activities have you found effective?  Share with all of us in the comments section.  If you have a “BABE”  to share in future posts – please contact me and let’s talk. – SM

About Cara Terreri, LCCE

© Cara Terreri

© Cara Terreri

Cara is a Lamaze Certified Childbirth Educator, doula, and site administrator for the Lamaze parent blog, Giving Birth with Confidence. She teaches and works in Myrtle Beach, SC, where she lives with her husband and three children. You can learn more about Cara at Simple Support Birth.

 

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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. 

 

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