Science & Sensibility

Do your expectant clients ever ask you whether other pregnant women are sensitive to strong smells?  Do they wonder about the different ways to hold a baby while nursing?  Do postpartum women with whom you interact, wonder if their babies are hitting the right milestones?

Group care in both prenatal and postpartum periods of the childbearing years has been shown to improve birth, breastfeeding and parenting outcomes, parent satisfaction, and parent empowerment. Sharon Schindler Rising first took women out of the exam rooms and into a group setting for education, support, and prenatal care in 1994.  Her vision was to bring women together with the goal of empowering them, and giving them autonomy and responsibility for their care.  Centering Pregnancy® (CP) , CenteringParenting, and CenteringDiabetes can now be found in more than 300 U.S. locations and in several foreign countries as well.

The University of North Carolina’s Department of Family Medicine started providing CenteringPregnancy® group care in 2002 and about half of our 170 prenatal patients annually choose group care, as an extension of their () individual care, versus individual care, alone.  UNC Family Medicine provides an average of 250 group visits per year.

Group care was successful for both diabetics (starting in 2001) and prenatal parents and was followed in 2006 with group care for well child visits.  The program is called WellBabies and follows the routine preventive schedule developed by the American Academy of Pediatrics.  Like group prenatal care, the intention is to educate, to empower, and to provide care for parents and their babies .  Both groups meet in the same friendly room where the initial prenatal visit takes place.   There are differences in numbers and types of visits that appears below:

Not many assessments of group versus individual care have been done.  However, evidence shows that after experiencing group care, parents valued support from other women, developmental comparisons, learning from others’ experiences, increased parental involvement in well-child visits, and more time with care providers.  In the Fall 2011 issue of the Journal of Perinatal Education a study of “Midwives’ Perceptions Of Implementing the CenteringPregnancy Model of Prenatal Care” recommends, “that individual providers and professional organizations embrace the CP model of group prenatal care and that more midwifery, nursing, and medical schools integrate CP into their obstetrical/maternity curricula.” (Baldwin and Phillips, 2011).

Group care embodies the definition of patient-centered care by the Institute of Healthcare Improvement and the Institute of Medicine’s (2001) report, “Crossing the Quality Chasm”.  Shared decision making and respecting patients and their families as partners in health-care are assets of patient-centered care found in group care and are endorsed by the National Committee on Quality Assurance, Institute of Medicine, Institute for Healthcare Improvement, as well as other professional healthcare organizations.

References_B Hotelling_blog post

Posted by:  Barbara Hotelling, MSN, WHNP-BC, LCCE, CD(DONA)

Barbara has been an active birth doula and Lamaze educator for over 25 years. She maintains her certifications with DONA International and Lamaze International, is on the Lamaze Faculty and is an approved DONA Doula Trainer. In addition to teaching Lamaze seminars for training childbirth educators and doula trainings, she has taught Labor Support for Nurses, Labor Support and the Teen Specialist programs of Lamaze throughout the United States , Canada, and in Korea. Barbara has served as President of DONA International, Chair of the Coalition for Improving Maternity Services (CIMS) and President of Lamaze International. Presently she serves on the Certification Council of Lamaze International and the Leadership Team of CIMS.

Childbirth Education, Guest Posts, Patient Advocacy, Preconception Care, Science & Sensibility, Uncategorized Barbara Hotelling, Centering Diabetes, Centering Model, CenteringParenting, CenteringPregnancy, group prenatal care, lamaze, UNC Famiy Medicine, WellBabies

 [Editor's note:  I recently came across this MedPage Today article about hospitals which continue to hand out infant formula, despite best evidence which tells us it is not a justified practice in most cases.  In this post, Internationally Board Certified Lactation Consultant, Marsha Walker, shares her thoughts on the topic.  Additional information about how to assist hospitals in stopping the practice of formula distribution can be found here.  A list of formula sample bag-free hospitals can be found here. To read Lamaze International's policy on product advertising (which pertains to infant formula), go here.]

Distributi­on of commercial formula discharge bags is a form of marketing, defined as such by HIPPA. These bags are not designed to provide full informatio­n on infant feeding methods. That is something that should be done by health care providers, not infant formula companies whose goal is to sell more products. Most of the informatio­n contained in these commercial discharge bags is biased to say the least. Peddling pricey products to vulnerable patients is hardly what could be called evidence-b­ased care. Hospitals who engage in this practice have morphed into the marketing arm of formula companies. No other unit in the hospital endorses brand name products and urges their patients to act in a manner that may not be in their best interest. These bags are not free. They cost the mother at least $700 as they promote the most expensive brands of formula, urging her to use those rather than the less expensive store brand formulas. It is time that hospitals stop acting as a sales venue and start providing breastfeed­ing mothers with sufficient evidence-b­ased breastfeed­ing care and the services of Internatio­nal Board Certified Lactation Consultant­s, rather than as a front and shill for the formula industry.

Guest Posted by:  Marsha Walker, RN, IBCLC

Breastfeeding, Science & Sensibility breastfeeding, hospital policies about infant formula, infant formula, infant formula samples

Each of us has many titles in both our personal and professional lives.
I have a new title, “President of Lamaze International.”  I feel honored and deeply responsible to spread the message of our mission and plans for the year.
I have been in the company of many of my Lamaze “heroes” and now find myself in the unique position of spreading our message  in the company of many of those heroes.  We are the ultimate advocates for safe and healthy birth that is evidence based and research supported.  We are Lamaze.

I love my title of “mom.” Although it has been several years since the birth of my three daughters, I have been able to see birth through their eyes, as they are all new mothers themselves.  I have seen my youngest daughter seek advice and information from a variety of internet-based sources, many of which are not the best, most reliable bits of information, but are based on anecdotal, high tech recommendations of online strangers who are her age.  I have seen some of the latest myths and misperceptions, and I have gently guided her and her friends to the right sources.   I have taught her and her friends Lamaze classes, as well as many, many other pregnant women.

I inherited the title of “Emie” (my grandmother name) seven years ago.  I was present at the births of my grandchildren and have marveled at the strength and determination of each of my girls as they adjust to the responsibilities, challenges and joys of motherhood.  They have become strong advocates of optimal treatments and advice for themselves and their little ones, all ten of them.

At the Steering Change for Safe and Healthy Birth Conference in Fort Worth last month, I adopted another title.  I was invited to proudly say, “I am Lamaze.”   We are each the face of Lamaze to our family, friends, and community.  I hope to wear that title proudly. This is why those of us who have many years of Lamaze teaching experience have rebranded our message and are moving forward to reach and teach the current generation of women about making choices for their own safe and healthy births.  We are adapting our formats and our tools to make our message reachable and teachable around the world.  Those of us who have done this passionately for many years are also in the position to mentor the next generation of Lamaze leaders and I look forward to that opportunity   We are expanding our consumer education online to introduce ourselves to the newest generation of expectant parents, and to make people aware of the need for Lamaze Certified Childbirth Educators in their communities.  We are increasing our footprint in the nursing and medical world through workshops and seminars.  We have big plans to grow the organization now and in the future.  I invite you to become an active part of our organization by sharing your time, talents and titles.

Thank you for letting me share time and titles with you.

Posted by:  Michele Deck, RN, MEd, BSN, LCCE, FACCE

Uncategorized importance of titles, Lamaze Board of Directors, Lamaze International, Lamaze president, Lamaze's mission, Michele Deck

[Editor's note:  Have you ever wondered how to best compel your clients or would-be students into taking childbirth education seriously, and spending the time to research and seek out a solid, evidence-based childbirth preparation class?  The following is from yesterday's Lamaze International press release.  Share this with your colleagues and local birth networks.  Heck, you might even want to print some copies off and post them in some visible public spaces in your community.]

-Best Courses Teach Evidence-Based Practices to Improve Chances of Having Safe, Healthy Birth-

WASHINGTON–A recent report from the World Health Organization set off alarm bells for many expectant parents.  The report showed that newborns in 40 countries, including Cuba, South Korea and Poland, have a lower risk of death than newborns in the United States.

For expectant moms, one of the best, and often overlooked, ways of improving the odds of a safe and healthy birth is to take a good childbirth education class.  But how do moms know whether they are choosing a class that will make a difference?

“A good childbirth education class can make the difference between feeling out of control and overwhelmed, and being able to handle the expected and unexpected on the day of your baby’s birth,” said Marilyn Curl, President of Lamaze International.  “A really good class will also help moms-to-be avoid routine interventions like inductions and being confined to bed, which can actually increase the risks around birth.”

Here are some factors mothers-to-be should consider when selecting a childbirth education class:

1. Research the Class Curriculum

Ask to see the content covered in childbirth courses carefully before selecting one.  There are a variety of curriculums, and different approaches may work better for different people.  Some courses do little more than orient women to the procedures of the hospital, regardless of whether those protocols are backed by research findings.

Curl cautions that women should be wary of ‘patient obedience classes.’  “Any class that simply focuses on what women are or are not allowed to do according to the procedures of the institution is not going to equip them properly for labor and birth.” Curl said.

Expectant parents should consider what they want to gain from taking the class and make sure those points are part of the curriculum.  Lamaze classes focus on educating parents about six safe and healthy birth practices that are based on extensive clinical research.  “Women rarely receive all of the best care practices, so it is critical for parents to educate themselves about their options,” Curl said.

Typical topics covered in Lamaze childbirth education classes include:

• Normal labor, birth and early postpartum
• Positioning for labor and birth
• Pain management techniques
• Labor support
• Communication skills
• Comfort measures, including breathing strategies, relaxation and massage techniques
• Risks and benefits of medical procedures
• Breastfeeding
• Healthy lifestyles

If the instructor teaches the class in a hospital setting or in a doctor’s office, parents should ask whether the instructor feels she has the freedom to discuss controversial topics related to childbirth and whether the class will discuss strategies for broaching these subjects with their care providers.  This information can help parents evaluate whether the class will focus on teaching the safest birthing practices, rather than explaining hospital policies.

2. Consider the Instructor’s Training

Check what kind of experience and background the prospective teacher has and ask about the instructor’s certification.  Lamaze offers the only internationally recognized childbirth educator certification program that is accredited by the National Commission for Certifying Agencies (NCCA).  Lamaze Certified Childbirth Educators must pass a rigorous examination to show they meet the highest professional standards and have the necessary knowledge and skills to teach courses.  To find a local Lamaze Certified Childbirth Educator (LCCE), visit www.lamaze.org.

3. Invest Some Time

Between work schedules, family obligations and setting up the nursery, expectant parents may feel pressed for time.  But parents-to-be need to make certain they devote plenty of time and attention to preparing for labor and birth.  A one-day crash course might sound like the quickest way to get up to speed, but parents may not retain as much information from a course taught in this format.  Online forums and TV shows focusing on birth do not offer personalized or in-depth information that’s found in a class.

Lamaze classes typically provide 12 hours of instruction and discussion.  The classes are spread across six weeks to ensure parents have time to absorb the lessons and consider priorities as the big day draws closer.  “It may seem like a big time commitment, but nothing is more important than preparing for a safe and healthy birth and a good start for the baby,” Curl said.

4. Plan Ahead

Classes fill up quickly, so start researching courses early.  Try to sign up for a Lamaze class six to eight weeks ahead of time – around the first week of the second trimester.

5. Check Class Size

For first-time parents, in particular, having personalized attention from the instructor is an important part of a childbirth education class.  Ask about the size of the class.  Ideally, there should be a maximum of 12 couples enrolled to ensure each has a chance to interact with the instructor and ask questions.

Choosing a class with an informative curriculum, a knowledgeable instructor and personalized attention are crucial for ensuring expectant parents have their questions and concerns addressed before the baby’s birth.  More information on childbirth education courses is available at www.lamaze.org.
About Lamaze International
Lamaze International promotes a natural, healthy and safe approach to pregnancy, childbirth and early parenting practices.  Knowing that pregnancy and childbirth can be demanding on a woman’s body and mind, Lamaze serves as a resource for information about what to expect and what choices are available during the childbearing years.  Lamaze education and practices are based on the best and most current medical evidence available.  Working closely with their families, health care providers and Lamaze educators, millions of pregnant women have achieved their desired childbirth outcomes using Lamaze practices.  The best way to learn about Lamaze’s steps to a safe and healthy birth is to take a class with a Lamaze certified instructor.  To find classes in your area, or for more information visit www.lamaze.org.

Childbirth Education, Evidence Based Medicine, Lamaze Method, Lamaze News childbirth preparation classes, Do I need to take a Lamaze class?, how to choose a childbirth class?, Lamaze Classes

Pregnancy and childbirth exploded onto the web scene in the very early 90s. I know because I was here participating in that explosion. I had no idea how dramatically it would change the way I worked as a childbirth educator and how it would alter how women received information about birth.

One of the most amazing things is how it’s brought so many like-minded individuals together and brought them into some amazing groups. I had a chance to spend some time with a group of people that felt very similarly to the way I feel about using technology as a part of health education, but a group that just a few years ago I never would have seen myself as a part of – the Centers for Disease Control and Prevention.

They recently hosted their fifth annual Healthy Communications, Marketing and Media conference in Atlanta. It was so amazing to be there with 1200 others and all talking about how to use the power of the Internet to reach more and more people and to do so effectively. I learned many amazing things while I was there and met some amazing people, but I wanted to share some really interesting points from the conference:

• Parents are all different.There was a whole session on how different parents are as individuals in a group. This is one of those duh moments; of course parents are different. But stop and ask yourself, is your class or is your information set up to recognize, celebrate and accommodate these differences? Or are your classes and messages the same all the time? These differences go beyond the obvious, moms are different than dads, but even within a group of mothers, you’ll have significant differences that should dictate how you convey  information. Knowing what to do will depend on how well you know your audience.   Examples might include a different reading level or health literacy levels; written and verbal information; online and in class and many other types of interactions.

• It’s not enough just to show up.Sometimes we think that simply owning a Twitter account or a Facebook account is enough. We put out a tidbit or fact and call it a day. Sure, someone is going to see that and perhaps even forward it on, but your reach will be very limited. What really matters is conversation. Having that conversation about a subject is key. If a user has a question and you discuss that question and answer, that’s going to go much further than you simply putting a posted fact on your Facebook wall. So engage people around your topics.

• Storytelling is important.In birth work, telling stories has always been something that we do. In childbirth class, I’ll share a snippet of a birth story to illustrate a point. It’s natural and works well with what my goals are for class. But how does this translate to the web? Storytelling has some really neat applications on the web, particularly through transmedia storytelling, the use of multiple platforms to tell a single story.

• Fail faster. The original intent of this message was that we spend a lot of time, perhaps years, on a project and then go overboard trying to make it succeed. This can be problematic because we don’t stick to the original outline and therefore can’t really figure out if the plan really worked or if it was the modification, etc. What I’m using this for in my world is that I should branch out and try different things. Don’t get comfortable or complacent. If something doesn’t work, it’s okay. Failure is a lesson and only a problem when you repeatedly do the same thing, failing over and over without making changes.

• Above all, listen. The theme for the conference was “Listen for Change.” And the message of listening really permeated the sessions. This is truly a key element. If we aren’t listening to those we are serving, are we really serving them? Do you ask your childbirth classes what information they want? Or do you simply serve up what’s on your curriculum? While it is certainly important to have the basics covered, have you considered adding a component of choice in? Perhaps allot a 15 minutes segment at the end of each class and allow students to choose from a variety of topics. While I wouldn’t put something core like comfort measures here, perhaps you have segments like baby wearing and anatomy of a breast pump as examples of options. The first night of class have 8-10 options, allow everyone 2-3 dots to “vote” for their favorites, and the “winners” are the topics taught. This is just one example of how to listen.

Overall this conference was an amazing and inspiring adventure. I would highly recommend that you attend this conference next year if you have any interest in media and health, from social media, to commercials, to news – there was something for everyone. The pace was very fast with 3 presenters for every 90 minute session, a definite change. The Twitter stream was lively, something I’m not used to for my usual conference attendings, but it really helped me feel like I was able to listen to many more sessions. So help me out on this last point and help me rip up the Twitter stream for the upcoming Lamaze Conference (#lamazemeet). I’ll look for you there.

Posted by:  Robin Elise Weiss, LCCE, FACCE is a childbirth educator in Louisville, KY. She lives there with her husband and eight children. While not playing with the kids she’s writing books and hanging out on Twitter. You can find her at http://pregnancy.about.com and @RobinPregnancy.

Conference Schedule, Different Methods for Different Questions, Guest Posts, Lamaze Annual Confernce, Social Media, Uncategorized CDC, Health Communications, Marketing and Media, Robin Elise-Weiss, social media + childbirth educators, transmedia storytelling