24h-payday

Lamaze International’s Parents Blog – Giving Birth with Confidence Seeks Your Expertise!

July 31st, 2014 by avatar

 My friend and colleague, Cara Terreri, is the Community Manager for the sister blog to Science & Sensibility, “Giving Birth with Confidence,” Lamaze International’s blog geared for expectant and new families.  Cara is looking for some guest writers, and that just might be you!  Read on to find out more.  - Sharon Muza, Community Manager, Science & Sensibility

Are you a maternal/child health professional with something to say or a passion to share? Giving Birth with Confidence, the Lamaze blog for parents, is seeking new voices to share relevant, up-to-date information with expectant parents everywhere. My name is Cara Terreri, and I manage and write for the Giving Birth with Confidence blog. I rely on my guest writers to share a range of topics and expertise with our readership. Guest posts on the blog can address a wide variety of topics pertinent to pre-conception, pregnancy, birth, postpartum, breastfeeding, and early parenting, and should be written in lay language, easily understood by the average person. Generally, articles are kept to a length of 1,000 words or less, but if the topic requires more, we can accommodate. Links, references and resources should be used where appropriate, and pictures (to which you own rights) are always appreciated! Below are a few topics on our current wish list, but please don’t hesitate to contact me with other ideas. 

  • growing research on the importance of colonizing baby’s gut after cesarean birth
  • options/choices if you experience a still birth
  • breastfeeding pain — difference between “normal” discomfort and pain, and what the pain could signal
  • resources for women on medicare and/or WIC during pregnancy/prenatal care
  • family centered cesarean
  • understanding fetal heart tones during labor (what are staff looking for with each 15 minute strip?)
  • rebozo 101 in labor
  • how to bond with your baby if you’ve been separated (NICU stay, etc)
  • relationship matters – during pregnancy, after birth
  • issues unique to single parents

We are also searching for our next Great Expectations blogger. If you or someone you know is in their first or early second trimester and would like to blog through their pregnancy experience (2 posts per month, through the first month postpartum), let us know!

Contact Cara Terreri to inquire about all guest writing opportunities.

Giving Birth with Confidence, Guest Posts, Uncategorized , ,

Early Bird Registration Closes August 1 for the 2014 Lamaze & DONA Confluence!

July 29th, 2014 by avatar

confluence header

This year’s Confluence (the special term being used to describe the 2014 conference hosted jointly by Lamaze International and DONA International in Kansas City, MO is shaping up to be simply an outstanding experience for all the attendees.  The confluence committee has put together an outstanding line up of speakers for the general sessions.

Pre-Conference Events

In the days  leading up to the confluence, attendees can register to participate in several different pre-conference events.  Choose from a three day Lamaze Childbirth Educator Seminar – one step on the path to becoming a Lamaze Certified Childbirth Educator.  This workshop is taught by the Denver-CPAC Lamaze-Accredited Childbirth Educator Program.  Take in the wisdom and experience of midwife Gail Tully, of Spinning Babies fame as she leads participants through a half day program designed for doulas, educators, doctors, midwives and L&D nurses.  Learn strategies and skills to teach to students and use with laboring women, when a malpositioned baby is interfering with the normal progression of labor and birth.   Patty Brennan, author of “The Doula Business Guide: Creating a Successful Motherbaby Business” leads a four hour business development workshop on establishing and growing a successful birth business and all that a birth pro needs to be successful.  Our final pre-conference offering is a full day “Evidence Based Nursing: Labor Support Skills” workshop designed especially for clinicians who want to help support safe and healthy birth through non-pharmacologic pain management strategies and hands on labor support skills. This workshop is taught by the amazing Kathryn Konrad.

Captivating General Session Speakers

Penny Simkin, Eugene DeClercq, Michele Deck, Katharine Wenstrom and Ngozi Tibbs are the plenary speakers at this year’s confluence and I could not be more excited.  These leaders in the field each bring their own diverse background and perspective to the confluence, while having the common goal to improve maternal infant health.  Learn more about the general session speakers and their background in this Science & Sensibility post.

Concurrent Sessions (focusing on four different tracks)

This year, there are four tracks of concurrent sessions!  Choose the track that most interests you or mix and match the concurrent sessions to customize a program that meets your individual needs.  Our four tracks are:

  • Evidence based teaching and practice
  • New and emerging research in the field of childbearing
  • Using technology and innovation to reach childbearing women
  • Supporting the needs of childbirth professionals

Enjoy the presentations of both seasoned presenters back again to share their wisdom and welcome those presenting for the first time, full of fresh and exciting perspectives and ideas.

Social Events

LCCEs attend the DONA Conference Photo Credit HeatherGail Lovejoy

Photo Credit HeatherGail Lovejoy

Half the fun of attending a professional conference is the opportunity to network and socialize with both new friends and old. The 2014 Confluence is no exception.  The Wine and Dine Event scheduled for Saturday evening at the beautiful Amigoni Urban Winery will include a custom designed wine tasting and gourmet dinner.  Your ticket includes RT transporation, to make it easy to enjoy the evening with a minimum of stress.

Exhibitors

When I attend conferences, I always make sure to leave plenty of time to browse the exhibit hall.  I love to see what new and innovative products are available for my doula and CBE practice.  Exhibitors from all over come to share what is hot and what is helpful and I love being able to ask questions about services from these experts and try out and examine all kinds of items useful for my business.  The list of exhibitors is long and full of well known companies who you will love to connect with in the Exhibit Hall.  For a list of those currently exhibiting, see our exhibitor list on the Confluence website. New exhibitors are being added, so check back frequently and be sure and stop by and say hi!

Register Now

There are many reasons to attend the 2014 Lamaze and DONA Confluence in Kansas City, MO September 18-21.  Take advantage of early bird pricing by registering by August 1 so that you can save some money and feel confident that all your continuing education and networking needs will be met by attending this fabulous Confluence.  See you in Kansas City!  Register now!

2014 Confluence, Childbirth Education, Confluence 2014, Continuing Education, Lamaze International , , , , ,

Lamaze International Introduces Online Parent Learning Center!

July 24th, 2014 by avatar

Screen Shot 2014-07-23 at 2.37.54 PMLamaze International has been working hard for many decades to make childbirth education classes available and accessible to a wide variety of women and their families.  Our training programs provide opportunities for men and women all around the world to complete a workshop and become a Lamaze Certified Childbirth Educator (LCCE) in the hopes that these educators can go on to teach Lamaze classes in their communities.  Despite new educators being added to the ranks all the time, many families are unfortunately still not able to find a Lamaze class in their community.  Some families, for a variety of reasons, may be unable to logistically attend an in-person class.

“This new online parent education initiative supports a key strategic imperative in Lamaze International’s newly adopted strategic framework – Innovate Education and Expand to the Childbearing Years. Through optimizing digital technology, expanding content offerings and providing online delivery, we hope to reach more women earlier in pregnancy and throughout their childbearing years with Lamaze education.” – Michele Ondeck, Lamaze International President

Lamaze International is pleased to announce that families who cannot attend an in-person class now have another option for Lamaze childbirth education.  The Lamaze Online Parent Center launches their first class, “Safe and Healthy Birth: Six Simple Steps” this week.  This online class offers an opportunity for parents to learn about the practices that support safe, normal, healthy birth and is based on the the Six Healthy Birth Practices that we all know so well and teach about in our classes.

This first online class has been developed by Lamaze International subject matter experts using the innovative online learning platform created by Thought Industries. Great care has been taken to create an online class that is interactive, engaging, informative and offers evidence based information in an easy to learn, understandable way for parents desiring an online option for their childbirth class.  Discussion forums, downloadable documents that support the curriculum, videos, interactive activities, stories, quizzes and more all come together to create an enriching online learning environment.

Parents participating in this online class are encouraged at many points to seek out an in-person Lamaze class in their community to access the skills and expertise of local LCCEs to help them to have a safe and healthy birth.

Screen Shot 2014-07-23 at 2.39.13 PM

The concept of online learning is more attractive than ever for today’s parents who view their smart phones, tablets and laptops as the perfect devices for accessing information when and where they want it. We are poised to meet the need of this new style of learner with our Lamaze Online Parent Center.  Birth professionals and families can explore the class in a quick preview and discover all the material that is covered.  Families can enroll right away and start and move through the class at their convenience. Families can also sign up to receive notification when the additional classes are launched.

After the launch of the “Safe and Healthy Birth: Six Simple Steps” online class, families will be able to participate in additional classes scheduled to be launched later this summer.  The new class topics will include “Prepared for Pregnancy: Start Off Right,” “VBAC: Informed and Ready” and “Breastfeeding Basics.”

 ”This initiative sets the stage for broader engagement with parents through online education, offering content in bite size pieces. It creates opportunities for educators to engage with parents in the online classes as moderators, to use as pre-work or an add-on to in person classes or private consultations, to serve as content experts for future class development, and as a referral source for in-person Lamaze classes where they are available.” - Lamaze International Education Council Chair Allison Walsh

Take a moment to look around the Lamaze Online Learning Center, peek at the pilot course and consider how these online classes can be an asset for parents to take advantage of, in addition to in-person participation. The “Prepared for Pregnancy: Start Off Right” course will hopefully generate primary interest in Lamaze offerings and motivate more families to seek out classes offered by Lamaze Certified Childbirth Educators local to them. As always, you can count on Lamaze International to continue to be a leader in evidence based childbirth education.

 

Childbirth Education, Healthy Birth Practices, Lamaze International, Push for Your Baby , , ,

Lamaze Releases Useful New Infographic: “No Food, No Drink During Labor? NO WAY!”

July 22nd, 2014 by avatar

piece Lamaze_RestrictedFoodDrinkInfographic_FINALToday, Lamaze International releases their newest infographic “No Food, No Drink During Labor? NO WAY!” This useful infographic is available on both the Lamaze International for Professionals website and the Lamaze Parents website. The most recent Listening to Mothers III survey indicated that 60% of women did not drink and 80% did not eat during labor! (DeClercq, 2013) The common practice of restricting food and drink for laboring women is outdated and not supported by evidence.  Unfortunately, most laboring women still face resistance from health care providers and facilities when they desire to eat or drink during their labor.

Lamaze International is hosting a Twitter Chat today, July 22nd, 2014 at 9 PM EST.  Professionals and parents are invited to participate in this live Twitter discussion moderated by Kathryn Konrad, MS, RNC-OB, LCCE, FACCE (@KkonradLCCE) and Robin Weiss, PhDc, MPH, CPH, CD(DONA), CLC, LCCE, Lamaze International’s President Elect. Tonight’s topic is “Restrictions in Labor” including this infographic on eating and drinking along with last month’s infographic on moving in labor (“We Like To Move It, Move It!”) Follow the hashtag #LamazeChat.  New to participating in a Twitter chat?  Check out this article for information on how to participate and get the most out of your experience.

Lamaze International’s Healthy Birth Practices, first released in 2009, discussed in great length the benefits to moving and changing position in labor in the 2nd Healthy Birth Practice: “Walk, Move Around and Change Positions Throughout Labor“ as well as the risks to restricting food and drink in the 4th Healthy Birth Practice: “Avoid Interventions That Are Not Medically Necessary.”

These useful infographics complement the Healthy Birth Practices, are easy to share on social media and can be used in the classroom as a poster to help parents to understand how to have the safest and healthiest birth possible.

Won’t you take a moment to check out this newest infographic and share with the expectant families that you work with!  Consider sharing it on your favorite social media outlet (Facebook, Twitter, Pinterest, Instagram) and making it available in your classrooms!

If you have an interesting way you are using these infographics, or would like to just share your thoughts on the infographic topics, please let us know in the comments section. I would love to hear how you use this info in your practice.

Click here to download the newest infographic “No Food, No Drink During Labor? NO WAY!”

You may access all the infographics available here!

References

Declercq, E. R., Sakala, C., Corry, M. P., Applebaum, S., & Herrlich, A. (2013). Listening to mothers III: Pregnancy and birth. New York, NY: Childbirth Connection.

Childbirth Education, Evidence Based Medicine, Healthy Birth Practices, informed Consent, Lamaze International, Maternity Care, Medical Interventions, Push for Your Baby , , , , ,

Non-Drug Pain Coping Strategies Improve Outcomes

July 17th, 2014 by avatar

 Today, contributor Henci Goer reviews a recently published study in the journal Birth, that compared the outcomes of births in women who received non pharmacological pain management techniques with women who received the “usual care” treatment.  The researchers found that maternal and infant outcomes were improved.  Take a moment to read Henci’s review to get a glimpse at the results and her analysis.- Sharon Muza, Science & Sensibility Community Manager

© Patti Ramos Photography

© Patti Ramos Photography

In 2012,  the Cochrane Database published an overview of systematic reviews of forms of pain management that summarized the results of the Cochrane database’s suite of systematic reviews of randomized controlled trials (RCTs) of various pain management techniques. Reviewers reached the rather anemic conclusion that epidurals did best at relieving pain—no surprise there—but increased need for medical intervention—no surprise there either—while non-drug modalities (hypnosis, immersion in warm water, relaxation techniques, acupressure/acupuncture, hands on techniques such as massage or reflexology, and TENS) did equally well or better than their comparison groups (“standard care,” a placebo, or a different specific treatment) at relieving pain, at satisfaction with pain relief, or both, and they had no adverse effects (Jones 2012). Insofar as it went, this finding was helpful for advocating for use of non-drug strategies, but it didn’t go very far.

Fast forward two years, and we have a new, much more robust review: Nonpharmacologic approaches for pain management during labor compared with usual care: a meta-analysis. Its ingenious authors grouped trials of non-drug pain relief modalities according to mechanism of action, which increased the statistical power to determine their effects and avoided inappropriately pooling data from dissimilar studies in meta-analyses (Chaillet 2014). The three mechanisms were Gate Control Theory, which applies nonpainful stimuli to partially block pain transmission; Diffuse Noxious Inhibitory Control, which administers a painful stimulus elsewhere on the body, thereby blocking pain transmission from the uterine contraction and promoting endorphin release in the spinal cord and brain; and Central Nervous System Control, which affects perception and emotions and also releases endorphins within the brain.

Overall, 57 RCTs comparing non-drug strategies with usual care met eligibility criteria: 21 Gate Control (light massage, warm water immersion, positions/ambulation, birth ball, warm packs), 10 Diffuse Noxious Inhibitory Control (sterile water injections, acupressure, acupuncture, high intensity TENS), and 26 Central Nervous System Control (antenatal education, continuous support, attention deviation techniques, aromatherapy). Eleven of the Central Nervous System Control trials specifically added at least one other strategy to continuous support. More about the effect of that in a moment.

Now for the results…

Compared with Gate Control-based strategies, usual care was associated with increased use of epidurals (6 trials, 3369 women, odds ratio: 1.22), higher labor pain scores (3 trials, 278 women, mean difference 1 on a scoring range of 0-10), and more use of oxytocin (10 trials, 2672 women, odds ratio: 1.25). Usual care also increased likelihood of cesarean in studies of walking (3 trials, 1463 women, odds ratio: 1.64).

Compared with Diffuse Noxious Inhibitory Control strategies, usual care was associated with increased use of epidurals (6 trials, 920 women, odds ratio: 1.62), higher labor pain scores (1 trial, 142 women, mean difference 10 on a scoring range of 0-100), and decreased maternal satisfaction as measured in individual trials by feeling safe, relaxed, in control, and perception of experience.

We hit the jackpot with Central Nervous System Control strategies (probably because female labor support, which has numerous studies and strong evidence supporting it, dominate this category [19 labor support, 6 antenatal education, 1 aromatherapy]). As before, usual care is associated with more epidurals (11 trials, 11,957 women, odds ratio: 1.13), more use of oxytocin (19 trials, 14,293 women, odds ratio: 1.20), and decreased maternal satisfaction as measured in individual trials by perception of experience and anxiety. In addition, however, usual care is associated with increased likelihood of cesarean delivery (27 trials, 23,860 women, odds ratio: 1.60), instrumental delivery (21 trials, 15,591 women, odds ratio: 1.21), longer labor duration (13 trials, 4276 women, 30 min), and neonatal resuscitation (3 trials, 7069 women, odds ratio: 1.11).

© Breathtaking Photography http://flic.kr/p/3255VD

© Breathtaking Photography http://flic.kr/p/3255VD

The big winner, though, was continuous support combined with at least one other strategy. Usual care in these 11 trials was even more disadvantageous than in central nervous system trials overall with respect to cesareans (11 trials, 10,338 women): odds ratio 2.17 versus 1.6 for all central nervous system trials, and instrumental delivery (6 trials, 2281 women): odds ratio 1.78 versus 1.21 for all central nervous system trials.

The strength of the data is impressive. Altogether, Chaillet et al. report on 97 outcomes, of which 44 differences favoring non-drug strategies achieve statistical significance, meaning the difference is unlikely to be due to chance, while not one statistically significant difference favors usual care. And there’s still more: benefits of non-drug strategies are probably greater than they appear because on the one hand, “usual care” could include non-drug strategies for coping with labor pain and on the other, many institutions have policies and practices that make it difficult to cope using non-drug strategies alone, strongly encourage epidural use, or both.

The reviewers conclude that their findings showed that:

Nonpharmacologic approaches can contribute to reducing medical interventions, and thus represent an important part of intrapartum care, if not used routinely as the first method for pain relief…however, in some situations, nonpharmacologic approaches may become insufficient…the use of pharmacologic approaches could then be beneficial to reduce pain intensity to prevent suffering and help women cope with labor pain…birth settings and hospital policies . . . should facilitate a supportive birthing environment and should make readily available a broad spectrum of nonpharmacologic and pharmacologic pain relief approaches. (p. 133)

No one could argue with that, but a persuasive argument alone is unlikely to carry the day given the entrenched systemic barriers in many hospitals. States an anesthesiologist: “While there may be problems with high epidural usage, in the presence of our nursing shortages and economic or business considerations, having a woman in bed, attached to an intravenous line and continuous electronic fetal monitor and in receipt of an epidural may be the only realistic way to go” (quoted in Leeman 2003). The Cochrane reviewers concur, writing that using non-drug strategies is “more realistic” (p. 4) outside of the typical hospital environs.

So long as this remains the case, attempts to introduce non-drug options are likely to make little headway. As Lamaze International’s own Judith Lothian trenchantly observes:

If we put women in hospitals with restrictive policies—they’re hooked up to everything, they’re expected to be in bed—of course they’re going to go for the epidural because they’re unable to work through their pain. . . . I go wild with nurses and childbirth educators who say, . . . “[Women] just want to come in and have their epidural.” I say, “And even if they don’t . . ., they come to your hospital, and they have no choice. . . . They can’t manage their pain because you won’t let them.” (quoted in Block 2007, p. 175)

Success at integrating non-drug strategies will almost certainly depend on addressing underlying factors that maintain the status quo. Can it be done? You tell us. Does your hospital take a multifaceted approach to coping with labor pain? If so, how was it implemented and how is it sustained?

Resources

Block, Jennifer. (2007). Pushed: The Painful Truth About Childbirth and Modern Maternity Care. Cambridge, MA: Da Capo Press.

Chaillet, N., Belaid, L., Crochetiere, C., Roy, L., Gagne, G. P., Moutquin, J. M., . . . Bonapace, J. (2014). Nonpharmacologic approaches for pain management during labor compared with usual care: a meta-analysis. Birth, 41(2), 122-137. doi: 10.1111/birt.12103 http://www.ncbi.nlm.nih.gov/pubmed/24761801

Jones, L., Othman, M., Dowswell, T., Alfirevic, Z., Gates, S., Newburn, M., . . . Neilson, J. P. (2012). Pain management for women in labour: an overview of systematic reviews. Cochrane Database Syst Rev, 3, CD009234. doi: 10.1002/14651858.CD009234.pub2 http://www.ncbi.nlm.nih.gov/pubmed/2241934

Leeman, L., Fontaine, P., King, V., Klein, M. C., & Ratcliffe, S. (2003). Management of labor pain: promoting patient choice. Am Fam Physician, 68(6), 1023, 1026, 1033 passim. http://www.ncbi.nlm.nih.gov/pubmed/14524393?dopt=Citation

About Henci Goer

Henci Goer

Henci Goer

Henci Goer, award-winning medical writer and internationally known speaker, is the author of The Thinking Woman’s Guide to a Better Birth and Optimal Care in Childbirth: The Case for a Physiologic Approach winner of the American College of Nurse-Midwives “Best Book of the Year” award.An independent scholar, she is an acknowledged expert on evidence-based maternity care.  

Childbirth Education, Doula Care, Epidural Analgesia, Guest Posts, Maternity Care, Medical Interventions, Newborns, Research , , , , ,