Author Archive

The Numbers Are In – Good News on Key Birth Statistics, But Work Still to Be Done

October 13th, 2015 by avatar

the numbers are inLast week, the National Center for Health Statistics (NCHS), part of the Centers for Disease Control (CDC) released 2014 information from the National Vital Statistics System, which works collaboratively with the NCHS.  This information comes from birth certificates and captures all births that have occurred in the United States during the reporting period.

There was definitely some good news amongst the mammoth report. Here are some highlights:

General Fertility Rate

The general fertility rate (GFR- number of births/1,000 women) increased to 62.9 per 1,000 women between the ages of 15 to 44..  This increase is the first increase since 2007.  Birth rates often decrease during periods of national financial instability.  Possibly, people are feeling more positive about the economy and their own financial security. While the increase from 2013 to 2014  was only 1%, things may be turning around as it has been an eight year streak of consecutive decreases.  it should be noted that non-Hispanic white women and Asian Pacific Islanders both had an increase in the GFR, the rate remained unchanged for non-Hispanic black women.  The fertility rates of Hispanic and American Indian or Alaskan Native women both hit historic lows.

Teen Birth Rates

The birth rates amongst teens aged 15-19 declined to historic lows for all teens as well as for each race and Hispanic origin group.  The birth rate for teens aged 15-19 dropped 9% from 2013 to 2014.   It was 24.2 per 1,000 females aged 15-19.  Comparing the 2014 rate to 2007, the rate has dropped 42%!

Cesarean Rates

The cesarean birth rate was 2014 was 32.2%, down from 32.7% in 2013.  The 2014 cesarean birth rate is down 2% from the high of 32.9 in 2009. Of significance – the cesarean delivery rates for non-Hispanic black, Hispanic and Asian/Pacific Islanders declined for the first time since 1996.  These groups have had 18 consecutive years of increasing cesarean birth rates.  Non-Hispanic white women have consistently had the larger declines.

Preterm Birth Rates

The number of babies born before 37 completed weeks of gestation declined again to 9.57% of all births.  Since 2007, the percentage of preterm babies is down 8% since 2007.  In 2014, non-Hispanic black infants were about 50% more likely to be born preterm than non-Hispanic white, Hispanic, and Asian/Pacific Islander infants.  Many campaigns, such a “Go the Full 40” (AWHONN) and “A Healthy Baby Is Worth the Wait” (March of Dimes) and others by additional organizations have been effective at reducing the number of non-medically necessary inductions before 39 weeks.

If you are interested in all the data – or even accessing the raw data for your own analysis, head over to the NCHS/CDC Vital Statistics website to download the reports or databases of your choice.

Leapfrog Group Releases Hospital Cesarean Rates

© Leapfrog Group

© Leapfrog Group

Additionally, last week, The Leapfrog Group – a nonprofit national watchdog group whose mission is to imporove the safety, quality and affordability of health care by a) supporting informed health care decisions by those who use and pay for health care; and, b) promoting high-value health care through incentives and rewards, released a national cesarean rate by hospital report.  This report, readily available to consumers, includes information on 48 states and Washington DC.  You can read the full press release here.

1122 hospitals voluntarily responded to the 2015 Leapfrog Hospital Survey.  Upon analysis, it was determined tht over 60% of reporting hospitals had excessive rates of cesarean sections.  The Leapfrog Cesarean Report collaborated with Childbirth Connection to help explain the information contained in the report.

The report contains the NTSV cesarean rates for the 1122 hospitals.  NTSV refers to a first time (nulliparous) pregnancy, that is full term (37th week or later) and there is one fetus (singleton) in the vertex (head down) position.  The NTSV cesarean section rate is recognized as being directly associated with quality improvement activities that are being implemented to reduce the number of unnecessary cesareans.

The cesarean section target rate for NTSV population that the Leapfrog Group adopted is 23.9% based on a proposal by the HealthyPeople.gov’s 2020 initiative, which seeks to improve the health and well-being of women, infants, children and families by the year 2020. It is important to realize that this NTSV rate is not the overall cesarean rate, which is much higher as it includes all births, not just those NTSV births.

“This is really about how well we, as doctors, nurses, midwives, and hospitals, support labor. Hospital staff that support labor appropriately and are sensitive to families’ birth plans are shown to have lower C-section rates overall. If we want to improve this rate across the board, then hospitals must hold themselves to this standard to ensure safe short- and long-term outcomes for both mom and baby.” Elliott Main, M.D., chair of Leapfrog’s Maternity Care Expert Panel and medical director of Stanford’s California Maternal Quality Care Collaborative.

Utah had the lowest number of NTSV cesareans at 18.3%.  Kentucky was last with an NTSV cesarean rate of 35.3%.  (Not all states had sufficient hospitals reporting data to calculate their ranking)

Consumers can find out the ranking of hospitals in their state by following this link.  There is also a very helpful section in this report that includes information on how consumers can help navigate their maternity health care options to prevent unnecessary cesarean sections.

As a childbirth educator, will you share this information with the families you work with?  How will you help them to understand the importance of their choice of birth locations?  How can you help families to navigate this situation when they do not have the freedom of choice or do not have an alternative available to them?








Martin JA, Hamilton BE, Osterman MJK. Births in the United States, 2014. NCHS data brief, no 216. Hyattsville, MD: National Center for Health Statistics. 2015.



what does it mean when the hospital doesn’t report

transparency acts of mass and NY

and if a firm like leapfrog can’t get them imagine how hard for average consumer


Cesarean Birth, Childbirth Education, New Research, Newborns, Pre-term Birth, Research , , , , , , , , ,

Series: Building Your Birth Business: Blog for a Business Boost!

October 8th, 2015 by avatar

BloggingForBusinessMaintaining a blog as part of your website is an excellent way to keep your website content fresh, share useful information with clients (and potential clients!), and increase and maintain an excellent ranking in the search engines that crawl the web.  In simplistic terms, a good SEO ranking means your website comes up at or near the top when people are looking for the services you (and your competitors) provide.  Today, contributor Andrea Lythgoe, LCCE, shares how she easily keeps her website updated with new material by curating a weekly blog and also writing new content as well.  The benefits to her business are measurable and really help!  You can do it too!  Andrea shares some quick and easy ideas for adding a blog to your business website and giving your business a boost! – Sharon Muza, Community Manager, Science & Sensibility

Many birth professionals want their website to rank well in search engines so they can be found by potential clients and students. When it comes to staying at the top of the search results, it is important to keep your site current. Essentially, the search engines assume that “If you’re not updated, you are outdated” and a site that doesn’t change hurts you in the rankings. The easiest way to keep your website current and fresh is to keep an updated blog on your site. The “on your site” part is important. For best SEO, your blog should be integrated into your web site, not a separate blog hosted elsewhere.  Blogging on a different platform like Blogspot or WordPress.com is easy, but separating it from your main site does not give you the benefit of a blog that is an integral part of your site.

I find that having a blog also gives people a reason to come back and visit my site often or subscribe to receive my posts regularly, and this keeps me in their minds throughout their pregnancy. It helps me share my thoughts and personality in a way that connects with potential clients. My work can be shared in other venues and amplifies my voice and gets my information out in front of more potential students.

The hardest part of blogging by far is coming up with ideas. Over the years, I’ve gotten better at coming up with ideas and I can find inspiration in many places. Here are some examples of when the blogging muse has spoken to me:

Occasionally I write an article because I am annoyed or angry about something. In these cases, I write it and save it in draft form, waiting at least a week before I look at it again. Often I find that I need to tone those types of articles down before publishing, but those posts tend to be the ones that resonate well with my readers. I find it best to write articles when I am feeling inspired and motivated. But because I’m not always inspired to write full articles, the bulk of my blogging is a weekly feature I call the “Wednesday Wrap Up”.

I use this weekly feature to curate content – I’m reading lots of blogs, following birthy people on Pinterest, and have some useful Google Alerts that help me find and read articles anyway, so I started sharing some of the most interesting finds with my readers. I make sure that I am using links, not reposting full articles. Reposting articles is an ethical no-no, plus you can share more if you use a collection of links.

With each link, I add a little commentary. Just a sentence or two – adding some original words or thoughts  instead of just a list of links helps add the original updated content that the search engines are looking for and reward. Having that weekly deadline helps me to make sure that my website has new content added regularly. . I aim for the weekly update plus two other articles each month. Some months I meet that, some months all I do is the weekly update. The weekly feature keeps me at the top of the search engine lists even when I don’t feel inspired.

Whenever I post a Wednesday Wrap Up, I immediately start a draft of the new one. Any time I see a good article in my blog reader, my Pinterest feed, or shared to Facebook or Twitter, I add it to the draft. I try to add my commentary at the time I read the article, but sometimes I get lazy and just have a list of links to work from on Tuesday evening. I aim to have five to ten links to share each week. If I get ten links and it isn’t Wednesday yet, I go ahead and schedule that post to run on Wednesday and start a new draft for the next Wednesday. At times I’ve been two or three weeks ahead, and at times I’m scrambling on Tuesday evening (or even Wednesday morning!) to find links to fill it. When I first started out, I shared a video each week as well, but I found that it took too much time to find and choose the links, and if not a public video, I needed to  get permission to embed the video. Therefore,  I recently simplified and now just share links.


When blogging, ALWAYS include an image or graphic with each post. Pinterest is a huge way of reaching women of childbearing age on social media, and without a photo or graphic, your blogging won’t be “pinnable” and cannot be shared. Make sure you stay on the right side of copyright law and make your own or use others with permission.

Articles you write don’t have to be long, just long enough to make the point clearly. If you have a longer post, consider breaking it up into a series. Expert opinions vary, and the trend seems to be towards longer posts, but most sources say the ideal length for a blog post is between 500-1000 words. Use as few words as possible to make your point and don’t pad a post to make it longer than necessary.

Find your voice – you can be casual or professional, but stick with it and be consistent. I choose to be very casual on my web site. I want to come across as someone they can sit down and have a nice visit with. I do not want to come off sounding distantly professional. The choice is yours; either approach can work well, just be very aware, conscious and consistent in using your voice.

Pay attention to proper spelling and grammar. Because I use a more casual voice on my blog, I will sometimes use words like “kinda” but I try hard to not have any spelling errors and to use apostrophes incorrectly, etc.

Blogging can be a rewarding way to keep yourself relevant and to increase your rankings in the search engines. It is a valuable tool that you can use to build your business and reach your target market. Start today by sitting down and brainstorming a list of topics. If you are inspired by this article and start blogging (or recommit to that blog that you have been neglecting) please post a link to your new post in the comments below!

About Andrea Lythgoe

Andrea Lythgoe

Andrea Lythgoe

Andrea Lythgoe is a doula, hospital-based Lamaze childbirth educator, birth photographer, and former instructor at the Midwives College of Utah. She is the author of the websiteUnderstandingResearch.com where she aims to help those just beginning to read research to understand the language of research. Her interest in research started while attending the University of Utah, where she made ends meet by working on a large randomized controlled trial and earned a degree in community health. Andrea served on the Board of Directors for the Utah Doula Association for over 10 years. She lives and practices in the Salt Lake City, Utah area. Andrea can be reached through her website.

Childbirth Education, Guest Posts, Series: Building Your Birth Business , , , , , ,

Interview with Alice Callahan about Science of Mom: A Research-Based Guide to Your Baby’s First Year.

October 6th, 2015 by avatar

In an earlier post on Science and Sensibility, regular contributor Anne Estes, PhD reviewed Science of Mom: A Research-Based Guide to Your Baby’s First Year, a new evidence-based book focused on answering questions on health, sleeping, and feeding for an infant’s first year. The book grew out of author Dr. Alice Callahan’s blog, Science of Mom, that she began writing as a new mother. Dr. Callahan took some time out of her busy schedule to talk with Anne about her new book and how it might be helpful for childbirth educators and new parents.  Readers will also want to pop over to Anne’s blog – Mostly Microbes, to listen to a podcast of  a more detailed interview with Dr. Callahan, the author of The Science of Mom. We’d also like to congratulate Amy Lavelle for being randomly chosen from the commenters on the original post. Amy wins herself a free copy of the book.  We hope that she will enjoy reading it.  – Sharon Muza, Community Manager, Science & Sensibility.

Science of Mom Cover HiDefAnne Estes: What do you see as the role of this book for childbirth educators and other birth professionals?

Alice Callahan: First, my book gives a really in-depth look at several newborn medical procedures, including timing of cord clamping, the vitamin K shot, and eye prophylaxis, plus shorter sections on newborn screening, the hepatitis B vaccine, and the newborn bath. Childbirth educators will take away a clear understanding of the evidence behind these procedures, and they can pass that knowledge onto students and clients. Second, and just as useful, those in-depth sections serve as excellent case studies for how to look at scientific evidence. My hope is that this background will give readers the tools needed to evaluate scientific evidence on their own as they encounter new questions – and I’m sure birth professionals are constantly faced with new questions!

AE: Why should childbirth educators suggest your book as a resource for interested parents?

AC: New parents are often taken off guard by the number of questions they have about childbirth and caring for a new baby. In online forums and playground conversations, they’re suddenly thrown into discussions of what is best for babies, and they find themselves trying to sort through lots of conflicting opinions and misinformation, trying to make the best choices for their own babies. It’s tremendously valuable and empowering to be able to understand how science can inform these decisions and how to find evidence-based resources. My book not only gives parents evidence-based information on infant health, feeding, sleep, and vaccines, but it also illustrates for parents how to find it themselves.

AE: What message from your book is most important for childbirth educators to share with their students?

AC: Seek evidence to inform your decisions. Be very skeptical of everything you read on the Internet, and make sure you’re getting your information from an accurate source. There’s so much misinformation out there that can be very misleading and even dangerous for parents and their babies. Don’t assume that something more natural or involving less intervention is always better. That isn’t always the case. Instead, look for objective evidence of risks and benefits, and make an informed choice.

AE: How did you choose the topics for your book? Was it difficult to decide what to leave out?

AC: I tried to choose topics that I think are some of the most common causes of confusion and anxiety for parents, based on questions that I get on my blog or that I see in online parenting forums. To be honest, my original proposal for this book included several more topics, but as I fleshed out chapters, I realized that it was more interesting to look at several topics in a really in-depth way rather than skim the surface on lots of different topics. But honestly, if I’d been able to devote another year or two to it, it could easily have been twice as long, because there are just so many great questions that parents have about the first year of life. I would have liked to cover topics like emerging research on the microbiome and concerns about chemical exposures, for example, but I may have to save those for another book!

AE: What do you feel is the most controversial topic in your book? 

AC: The safety of bedsharing is probably the most controversial topic in the book. Sleep practices are just so personal, and many parents really value bedsharing with their babies for cultural, emotional, or practical reasons. This is an area where you’ll find very conflicting advice, and everyone cites scientific studies to back their stance. In the book, I do my best to look honestly at the evidence for and against bedsharing safety. I explain that multiple studies do show risk of bedsharing in certain circumstances, especially with babies in the first few months of life, but I acknowledge the limitations of those same studies. And I also point out that individual factors, such as ease of breastfeeding or alternatives to bedsharing (including the risks of falling asleep with your baby on a couch or trying to drive a car while severely sleep deprived, for example) might make careful bedsharing a reasonable choice. I think we need to share all of this information with parents and discuss how to set up a bed to make bedsharing as safe as possible if that is the choice.

AE: Could you describe how you determine which findings from the scientific literature are best for answering a parenting question?

AC: In the book, I give a rough guide to types of study designs and explain which ones are most likely to give us strong evidence that is relevant to parenting decisions. Systematic reviews and meta-analyses are usually most useful, because they combine the results of multiple studies so are more likely to give us a big picture consensus about a question. (This assumes that the authors selected high quality studies for the review, so you have to be a little careful here.) Looking at single studies, randomized controlled trials are the best quality, whereas observational studies are usually limited by confounding factors and can only show correlations, not causation. Studies conducted in animal models or cell culture are an important step in scientific research, but we really want to see follow-up in human studies before we change our lives over the results. As you look at studies, you also want to pay attention to how many people were included in the study and whether or not the population is similar to your own. Evaluating scientific evidence takes some practice, and I go into lots more detail in the book.

AE: I was shocked to read that immediate cord clamping and cutting and stomach sleeping were practices changed in the mid-1900s without any evidence. Could you talk about how one of those practices began, the implications, and what it took (or will take in the case of umbilical cord clamping) for the original practices to be put back into place?

AC: It’s surprisingly difficult to pin down exactly when the shift to immediate cord clamping occurred, but it probably happened in the early to mid-1900s. Before this, it was likely standard practice to wait a few minutes or until the cord stopped pulsing before clamping it. The shift to immediate cord clamping seemed to coincide with the movement of birth from the purview of midwives in homes to obstetricians in hospitals. Immediate cord clamping was also part of the practice of active management of the third stage of labor, which was introduced in the 1960s. However, there was no evidence then that immediate cord clamping was beneficial to either mom or baby, and studies show that delayed cord clamping does not increase the mom’s risk of postpartum hemorrhage (which was a belief for a while).

Immediate cord clamping is an example of an intervention put into place because it was convenient, not because it was evidence-based. We now have good evidence that delayed cord clamping is beneficial to infants, especially those born preterm. For term infants, the biggest benefit is a boost in iron stores that can prevent iron deficiency later in infancy. There is some evidence that the risk of jaundice is increased, but as I discuss in the book, this is controversial. We’re seeing some obstetricians making delayed cord clamping their standard of care, but practice is really mixed in the U.S. At this time, ACOG recommends a delay of 30-60 seconds for preterm infants, but they refrain from making any recommendation for term infants, citing insufficient evidence. I actually appreciate that they’re careful to ensure there is adequate evidence before changing practice, but I do think we have enough evidence now that we should really be going back to delayed cord clamping whenever possible. I think that with a little more time and a few more studies, delayed cord clamping will again become standard practice, especially with doctors in the U.K. testing a resuscitation trolley that allows the cord to remain attached even if the infant requires resuscitation.

AE: What did you do to feel prepared for your labor and birth, and first weeks of parenting? Did you choose to take a childbirth class?  Do you feel it helped you feel prepared and confident?

AC: Before the birth of my first child, I took a childbirth class through a local hospital. It was very helpful in terms of knowing generally what to expect with labor and learning some ways to cope with discomfort. To prepare for the birth of my second baby four years later, my husband and I both read The Birth Partner by Penny Simkin. I liked that it was evidence based and a straight-forward source of information, and my husband put Simkin’s suggestions into action to truly be a great birth partner.

One of the most important aspects of birth preparation for me was developing a trusting and respectful relationship with my healthcare providers. My babies were delivered by two different OBs, and both were wonderful at communicating options to me as things progressed. Based on our discussions throughout pregnancy, I knew that I could trust them to be evidence based in their practice, and that helped me relax in labor and focus on my job of giving birth.

How did I prepare for the first few weeks of caring for a newborn? I did what women have been doing throughout the history of our species – I invited my mom to come and help! She was a wonderful help after the birth of both of my babies, and I felt lucky to have her.


AE: What future topics are you looking forward to writing about next?

AC: Readers of my blog keep me well-supplied with questions about parenting, and I have a huge list of topics that I’d like to tackle. One of my favorite areas of focus is nutrition, as that is the field of my PhD training, so I’d like to develop more information about infant nutrition on my blog.

While I was researching and writing my book, I had three miscarriages. That brought up lots of questions for me about miscarriage and infertility, but I didn’t have time to write much about these topics because I was working so hard on The Science of Mom. I’d like to write more about them now. I think there is a real need for compassionate and evidence-based writing about these tough topics.

About Anne M. Estes, PhD

AnneMEstes_headshot 2015Anne M. Estes, PhD is a postdoctoral fellow at the Institute for Genome Sciences in Baltimore, MD. She is interested in how microbes and their host organisms work together throughout host development. Anne blogs about the importance of microbes, especially during pregnancy, birth, first foods, and early childhood at Mostly Microbes.

Babies, Book Reviews, Childbirth Education, Evidence Based Medicine, Guest Posts, Newborns , , , , , ,

Brilliant Activities for Birth Educators – An Anatomy Ice Breaker

September 30th, 2015 by avatar
© Sharon Muza

© Sharon Muza

This month’s “Brilliant Activities for Birth Educators” is one of my old standbys. I use it frequently at the beginning of a series class.  Last week I started a new seven week series and did it again on the first night, and I really enjoy how this activity effectively meets many of my learning goals for the families in attendance.  It is also simple and easy, requiring little in the way of materials and supplies!   After this activity, families are able to discuss the location and purpose of anatomical structures important to the childbearing year, connect and engage with other families in the class and briefly discuss some common pregnancy changes (and discomforts) that result from a progressing pregnancy.

“I Can Draw Birth Anatomy and So Can You!”


I often start the class out with this activity up first – even before introductions.  It works great as an icebreaker and gets people connecting in small groups.  Families are up and out of their seats moving around the classroom.  Lots of laughter assures me that people are settling in and relaxing, ready to build confidence in their ability to birth by having fun and connecting with their community. Before the students arrive, I have placed the very largest newsprint I have up on the walls in several locations around the room.  I like to have two or three families working on one piece of paper, so I plan accordingly

anatomy 1

© Sharon Muza

How it unfolds – the instructions

At the start of class – I ask the families to self select into groups of two or three families and head to a piece of paper.  I pass out the colored markers to everyone.  Each family gets their own laminated anatomy parts card.  “As we move through our childbirth classes, we are going to be talking a lot about the amazing body and its many parts.  I always think it is a good idea to understand what these parts are called, where they are located and what they do.  In order to do this, I am asking you all to draw and label your own anatomy charts. Use the list as a guide, take turns and have fun. You have 8 minutes.”

The drawing begins

People quickly jump to the task, taking turns drawing and labeling the different body parts on their newsprint.  I circulate throughout the room, connecting, admiring and keeping things focused and moving along.  There are usually peals of laughter, lots of discussion and very engaged families.  The time flies by and I give the one minute warning that encourages them all to wrap up.  Before we all sit down again, we do a “gallery walk” and move through the room visiting all the posters, admiring and laughing some more.

drawing anatomy

© Sharon Muza

My turn

Once we are all seated again, I compliment the class on the excellent job and take out my own standard anatomy chart of the non-pregnant and full-term pregnant woman.  I point out the parts they were asked to draw on my chart and discuss the unique details of each. For example, when discussing the umbilical cord, we talk about how many veins and arteries, the reason the cord is often coiled, the average length of an umbilical cord and the function of Wharton’s jelly.  The position of the bladder under the baby’s head allows us to talk about frequent urination as the baby grows.  We move through all the parts and I continue to point out the function and unique and interesting facts.  I also weave in common discomforts and use the charts to demonstrate why they might have heartburn, shortness of breath, or a back ache.

The takeaway

While I certainly can cover anatomy for birth without the small group drawings, the families are spending the first minutes of the first class building community, connecting with each other in small groups, sharing a common goal and laughing while identifying the important body parts that we will be discussing.  I can then move confidently move on to group introductions and some of the more mundane housekeeping information that always needs to be shared.  But we are quickly through that and on to another fun activity.

anatomy 2

© Sharon Muza

Parent feedback

Families like to take pictures of their drawings and almost immediately the nervous tension of being at the “first childbirth class” has been broken with the fun and laughter.  If families are late to arrive, it is easy to join a group and quickly participate without much lead in from me.  The pregnant people enjoy seeing non-pregnant partners “struggle” to identify various parts and everyone reports that the “gallery walk” is almost as much fun as the drawing activity.  The families report that they leave this activity with some great images of the amazing pregnant body and the understanding of how everything works together to support and grow their beautiful babies.


This fun activity is a great icebreaker for a new class.  Interactive and self-paced, families laugh and connect over a common goal.  Do you think you might try something like this in your class?  Do you do something similar already?  How might you modify this activity to meet the learning objectives you have for your birth anatomy section?  Share your thoughts in the comments section below. I would love to hear them!

anatomy list

Childbirth Education, Series: Brilliant Activities for Birth Educators , , , ,

The Top Ten Safety Messages to Share with New Parents – September is Baby Safety Month!

September 28th, 2015 by avatar

By Jenny Burris Harvey, BA, CPST

JPMA-BabySafetyMonthLogo-OLSeptember is Baby Safety Month, and before the month entirely slips away, I wanted to acknowledge this and share some resources with childbirth educators that they can use in their classes.  I asked colleague Jenny Burris Harvey, BA, CPST, a skilled safety educator in Seattle, WA to share the top ten safety messages that birth professionals and others can make sure parents hear or receive information on during their prenatal classes.  While I acknowledge that there already is so much we want to cover during our classes, I urge educators to consider how they can pass this important information on to families.  If there is absolutely no time to mention these topics in class, consider putting out an information sheet with important resources and links that you provide to the families you work with.  It could save a life. – Sharon Muza, Community Manager, Science & Sensibility

Childbirth educators often find themselves in the awkward position of having a wealth of information to share with expectant families but not enough time to share it all. As you pick and choose what to spend your time on, consider that your class may be the only class that these families take in preparation for parenthood. While the bulk of what you teach will be about pregnancy, birth, and postpartum, you may have the opportunity to incorporate some key messages about keeping those new babies safe, as well.

© Jenny Burris Harvey

Beds are not a safe place to leave baby, especially with pets. © Jenny Burris Harvey

There’s never a safe time to leave a baby in an unsafe place. Most parents and caregivers assume that they’ll have at least a few months before they have to worry about having a safe place to contain their baby. They don’t expect that a new baby could roll off a couch, sit up and fall from a bouncy seat, or pull loose car seat straps around their neck. They don’t think about the cat jumping up on the bed being enough weight to knock the baby off or how deadly it can be to leave baby alone in the car for even a moment.

This simple message can be used in many contexts and easily incorporated into newborn care classes. It applies to holding baby, putting baby to sleep, wearing baby in a carrier, bathing baby, putting baby in a car seat, or even the logistics of getting dressed, going shopping, or any other aspect of daily life.

Here are a few other messages that, in my years of teaching, I have found to be the most valuable for new and expectant parents to hear from someone they trust.

1. Learn how to use the child’s car seat correctly.

Three out of four car seats are used incorrectly, meaning they would likely not be able to protect the child in a sudden stop or crash. A properly used car seat reduces an infant’s risk of injury or death by 71 percent. It’s not that car seat use is rocket science, it’s that it’s a big, often complicated puzzle. Parents should start by reading their car seat manual and their vehicle manual. Dr. Alisa Baer (The Car Seat Lady) has great tips on how to properly put a newborn in a car seat and safely keeping baby warm in cold weather. Urge parents to practice getting the harness straps nice and snug and the chest clip up to armpit level. Finally, emphasize the value of having their car seat checked by a certified child passenger safety technician (CPST). Make note of local resources in your area or have them go to Seatcheck.org to find a fitting station near them. Consider an educational handout, such as This is the Way the Baby Rides, but be sure to keep it current.

© Jenny Burris Harvey

Proper harness use on a newborn © Jenny Burris Harvey

Note: Please do not send families to any fire station, police station, or hospital without confirming that they do have a CPST who provides seat checks. If you want to learn more about child passenger safety, contact your local Safe Kids Coalition to find out about the CPS awareness classes or technician trainings nearest you.

2.  Keep the child rear facing as long as possible, at least two to three years.

The safest way to ride in a vehicle is rear facing. Rear facing children are 75 percent less likely to suffer head, neck, or spinal cord injuries in a crash. Experts agree that keeping a child rear facing until they outgrow the height or weight maximum for the rear-facing mode of their convertible car seat is the safest for the child. A study from the American Academy of Pediatrics found that children are five times safer staying rear facing until age two than turning around at age one. The National Highway Traffic Safety Administration recommends staying rear facing until at least age three. What everyone agrees on is to find a car seat that allows a child to stay rear facing as long as possible.

3. Learn about sleep safety.

To protect against sudden unexpected infant deaths (SUIDs), such as sudden infant death syndrome (SIDS) and accidental suffocation, it is recommended that baby:

  • Be put down on his back for sleep, every time he sleeps.
  • Sleep in his own crib or safety-approved sleep area in the same room as the parents.
  • Is breastfed.
  • Does not get overheated by clothing, sleepers, hats, or heaters.
  • Uses a dry pacifier as he falls asleep.
  • Has nothing else in the sleep area with him, including blankets, pillows, toys, or sleep positioners.

Safe sleep can be difficult to remain objective about for some childbirth educators. Always offer evidence-based best practice guidelines first, then offer some help on practical trouble shooting if things don’t end up working that way. Co-sleeping or bed-sharing is a controversial issue that can get heated pretty quickly. It’s important to acknowledge the risks involved, as well as the likelihood that parents might find themselves resorting to it at some point just to get some sleep. Offer resources on how they can learn more about how to share a bed with their baby as safely as possible. James McKenna and La Leche League offer well-researched and easy-to-read information on the topic.

Note: There are a number of great safe sleep guides for parents and caregivers, such as those from the American Academy of Pediatrics. Be sure you have the most current information on safe sleep, too. Sign up for updates from the Safe to Sleep campaign, the Infant Sleep Information Source, and watch for webinars and other professional training updates on safe sleep.

4.  Baby gadgets and gizmos cannot do a parent’s job for them.

There are many baby products that claim to keep a baby safe for parents, from heating bottles to the perfect temperature to protecting them from SIDS. While these products may be tempting, it’s important to know that most of them are not regulated and often offer a very false sense of security. Some products may make parents’ jobs a little quicker or easier, but they cannot keep a child safe for them. Baby monitor cords have strangled babies in their crib, many “safe sleep” products have been recalled due to injury or death, and aftermarket car seat accessories can jeopardize baby’s airway or their safety in a crash. Emphasize the importance of thinking through possible risks before using an unregulated product for a baby. Remind parents that nothing should replace supervision and following best practice guidelines for keeping their baby safe.

5. Falls are the leading cause of unintentional injury in the first two years of life, and most of these falls occur when the child is dropped by a caregiver.

Dropping the baby is a big fear for a lot of new parents. While we want to offer reassurance, we also need to acknowledge the validity of this fear and offer some tips for reducing the likelihood of it happening. Carrying only baby, having a good hold on the head and a hip, removing trip or fall hazards around the home, and keeping a little light on throughout the house at night are some of my favorite tips for helping parents not drop their little ones.

Babywearing is a great tool for caring for a baby who wants to be held while still giving parents some freedom to do other things. There are many different kinds of carriers, and they all have different rules and instructions. Families should make sure their carrier is safe for use with newborns and that they are able to use it correctly. Baby carrier manufacturers often provide tips and videos on proper use and Babywearing International has information online and local chapters where people can get hands-on help.

Learn more about reducing fall hazards around the home. Mounting walk-through baby gates at the top and bottom of stairs, using safety straps on baby products, using window guards, bolting furniture to walls, moving the crib mattress down before baby can sit up, and never leaving baby alone on a raised surface will all reduce the likelihood of a serious fall.

6.  It’s really, really stressful when a baby cries. Have a plan.

The average baby cries between one and five hours per day. Most crying is a late cue to let parents know that baby had a need that wasn’t met in time. If the need is met, she’ll stop crying. However, some crying will not stop, no matter how parents try to soothe their baby. This inconsolable crying often seems very severe, as if the baby is in pain. Caregivers often feel as though something is very wrong, either with their baby who won’t stop crying or with themselves because they can’t make it stop.

The Period of P.U.R.P.L.E. Crying offers information about inconsolable crying, including reassurance that, unless there are other symptoms or indicators, there is nothing wrong with the parents or their baby. Of particular note to new parents may be the findings that:

  • Inconsolable crying peaks around two months old.
  • Most babies have a regular fussy time, typically in the evenings.
  • Baby’s nervous system isn’t fully developed, which means she can’t fully control when she stops crying.

It is critical to address how difficult this is to cope with, even for loving caregivers, because it is the leading cause of abusive head trauma (Shaken Baby Syndrome). Shaken Baby Syndrome happens when the baby’s head is shaken front-to-back with enough force, even just for a moment, to cause permanent damage to the baby’s brain. Parents and other caregivers should have a plan for what to do when baby won’t stop crying. Getting support from their family and their community can help during this hard time. Having the phone number for the Fussy Baby Network or crisis hotline within easy reach at all times is also a good idea.

7.  Don’t try to fix a problem before it’s there.

Parents have access to so many baby products, baby care blogs and books, and parenting advice, it can be really easy to buy into the idea that they need to prevent common problems parents face before they start. “Oh, you have to get one of these baby seats because it’s the only way my baby would sleep for the first three months!” can sound pretty convincing to a parent who is anxious about not getting enough sleep. Seeing a rear-view mirror that allows a parent to see baby while he’s in his car seat could make a parent think that it would be dangerous to not be able to see him.

Many parents choose to do things that are potentially unsafe for their baby, based on purely good intentions, without having tried it the safest way first. Start with what is known to be the safest for the baby. If, after a good effort, that doesn’t work, then think about what the next safest option to try is. Be sure to consider the risks before trying alternatives.

bsm-hiddenhazards-infographic8.  Give the home a safety makeover.

Start with the basics. A home should be a safe place for the child to explore and learn about navigating the world around them. It should also be a place where parents don’t have to constantly worry about the baby’s safety.

Burns & Fires:

  • Scalds are the leading cause of burns in infants. Turn the water heater down to 120 F, use the back burners, and don’t eat, drink, or prepare hot things while holding a baby.
  • Have working smoke alarms, carbon monoxide detectors, and fire extinguishers on every level of the home and outside each sleep area. Have a fire escape plan that includes a safe way to get out from the upstairs with baby.


  • Program Poison Control 1-800-222-1222 into cell phones and call right away if there is a possibility that a child has been poisoned.
  • Include cosmetics and personal care items during child proofing, as they’re the leading cause of poisonings in young children.


  • It takes as little as 2 inches of liquid for a child to drown.
  • Most infants drown in the bathtub. Always have one hand on the baby in the tub.


  • Have first aid kits, with infant supplies, in the home, car, and diaper bag.
  • Have a plan and supplies for emergencies or disasters, including supplies for baby.

Anything with potential to cause life-threatening injuries must be child-proofed. Guns, knives, poisons, pools, staircases, and other immediate threats must be locked and inaccessible. Things that could potentially harm a child are more of a grey area where caregivers must weigh the risk versus the inconvenience of child-proofing and decide what their comfortable level of risk is.

9.  Learn CPR and Choking Rescue.

It is very unlikely that a baby will need Cardiopulmonary Resuscitation (CPR). However, if he does, it’s critical that parents know what to do. Choking is a common emergency in infants and young children, so it’s also important that parents are confident in performing choking rescue. Guidelines change every few years, encourage families to keep their skills current. The American Heart Association and American Red Cross offer CPR and choking rescue classes in hospitals and communities all across the U.S.

10.  Slow down.

We live in a culture of multitasking. Being stressed, distracted, or in a hurry greatly increases the risk of injury for the children we care for. From baby choking because a baby is being fed too fast, to dropping baby while trying to carry too many things at once, to forgetting baby in the back seat of the car while parents are busy talking on the phone, it’s dangerous to do too much at once. Slow down. Encourage parents to shift their priorities and give themselves some slack for a while. Get support when needed. A healthy, engaged parent is one of the best safety nets for a child.

While the topics may be very different than what you usually cover, the big concepts are very similar. Encourage families to educate themselves and get support so they can make informed decisions about their child’s safety from the very start.

What safety information do you like to share with the parents you work with?  What are your favorite resources for helping parents to learn how to keep babies safe?  Share your thoughts, ideas and resources in the comments section below. – SM


Decina, L.E., Lococo, K.H., & Block, A.W. (2005) Misuse of child restraints: results of a workshop to review field data results. Traffic Safety Facts: Research Note. Retrieved from http://www.nhtsa.gov/people/injury/research/tsf_misusechildretraints/images/809851.pdf

Durbin, D. & COMMITTEE ON INJURY, VIOLENCE, AND POISON PREVENTION (2011). Technical report – child passenger safety. Pediatrics peds.2011-0215. doi:10.1542/peds.2011-0215

Henary, B., Sherwood, C.P., Crandall, J.R., Kent, R.W., Vaca, F.E., Arbogast, K.B., & Bull, M.J. (2007). Car safety seats for children: rear facing for best protection. Injury Prevention, 13:6 398-402. doi:10.1136/ip.2006.015115

NEISS All Injury Program operated by the Consumer Product Safety Commission (CPSC). 10 leading causes of nonfatal injury, United States, 2003-2013, all races, both sexes, disposition: all cases. National Center for Injury Prevention and Control, CDC. Retrieved from WISQARS http://www.cdc.gov/injury/wisqars/nonfatal.html

About Jenny Burris Harvey

jenny burris harvey head shot 2015Jenny Burris Harvey, BA, CPST, is an educator, writer, and mom with a background in injury prevention health promotion, human development, and family support who specializes in infant injury prevention and child passenger safety. She has been supporting and educating families and professionals around child health and safety for many years, but found her passion in empowering new and expectant parents to keep their babies safe. With over ten years in the child passenger safety field, Jenny has worked and volunteered on a local, national, and federal level to educate families and professionals on proper car seat use. She also worked with Safe Ride News to create a continuing medical education module for pediatric healthcare providers. Jenny currently oversees and teaches Babysafe classes for Great Starts Birth and Family Education program at Parent Trust for Washington Children and is the co-author of the 5th edition of Baby & Me, a low-reading level book on pregnancy and newborn care.

Babies, Childbirth Education, Guest Posts, Newborns, Parenting an Infant , , , , ,

cheap oakleys fake oakleys cheap jerseys cheap nfl jerseys wholesale jerseys wholesale nfl jerseys