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A Tale of Two Births – Comparing Hospitals to Hospitals

December 9th, 2014 by avatar

By Christine H. Morton, PhD

Today, Christine H. Morton, PhD, takes a moment to highlight a just released infographic and report by the California Healthcare Foundation that clearly shows the significance of birthing in a hospital that is “low performing.”  This is a great follow up post to “Practice Variation in Cesarean Rates: Not Due to Maternal Complications” that Pam Vireday wrote about last month. Where women choose to birth really matters and their choice has the potential to have profound impact on their birth outcomes.   – Sharon Muza, Science & Sensibility Community Manager.

An Internet search of “A Tale of Two Births” brings up several blog posts about disparities in experience and outcomes between one person’s hospital and subsequent birth center or home births. Sometimes the disparity is explained away by the fact that for many women, their second labor and birth is shorter and easier than their first. Or debate rages about the statistics on home birth or certified professional midwifery. Now we have a NEW Tale of Two Births to add to the mix. However, this one compares the experiences of two women, who are alike in every respect but one – the hospital where they give birth.

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The California HealthCare Foundation has created an infographic drawn from data reported on California’s healthcare public reporting website, CalQualityCare.org. In this infographic, we meet two women, Sara, and Maya who are identical in every respect – both are the same age, race, and having their first baby, which is head down, at term. However, Sara plans to have her baby at a “high-performing” hospital while Maya will give birth at a “low-performing” hospital. “High performing” is defined as three or more Superior or Above Average scores and no Average, Below Average, or Poor scores on the four maternity measures. “Low performing” is defined as three or more Below Average or Poor scores on the four maternity measures.

Based on the data from those hospitals, the infographic compares the likelihood of each woman experiencing four events: low-risk C-section, episiotomy, exclusive breastmilk before discharge, and VBAC (vaginal birth after C-section) rates (the latter one of course requires us to imagine that Sara and Maya had a prior C-section).

First-time mom Sara has a 19% chance of a C-section at her high-performing hospital, while Maya faces a 56% chance of having a C-section at her low-performing hospital. These percentages reflect the weighted average of all high- and low- performing hospitals.

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The readers of this blog will no doubt be familiar with these quality metrics and their trends over time. Two of these metrics (low risk C-section and exclusive breastmilk on discharge) are part of the Joint Commission’s Perinatal Care Measure Set. The other two – episiotomy and VBAC are important outcomes of interest to maternity care advocates and, of course, expectant mothers.

Hospitals with >1100 births annually have been required to report the five measures in the Joint Commission’s Perinatal Care Measure Set since January 2014, and these metrics will be publicly reported as of January 2015.

Childbirth educators can help expectant parents find their state’s quality measures and use this information in selecting a hospital for birth. In the event that changing providers or hospitals is not a viable option, childbirth educators can teach pregnant women what they can do to increase their chances of optimal birth outcomes by sharing the Six Healthy Practices with all students, but especially those giving birth in hospitals that are “low-performing.”

You can download the infographic in English and en Español tambien!

About Christine H. Morton

christine morton headshotChristine H. Morton, PhD, is a medical sociologist. Her research and publications focus on women’s reproductive experiences, maternity care advocacy and maternal quality improvement. She is the founder of an online listserv for social scientists studying reproduction, ReproNetwork.org.  Since 2008, she has been at California Maternal Quality Care Collaborative at Stanford University, an organization working to improve maternal quality care and eliminate preventable maternal death and injury and associated racial disparities. She is the author, with Elayne Clift, of Birth Ambassadors: Doulas and the Re-emergence of Woman Supported Childbirth in the United States.  In October 2013, she was elected to the Lamaze International Board of Directors.  She lives in the San Francisco Bay Area with her husband, their two school age children and their two dogs.  She can be reached via her website.

Babies, Cesarean Birth, Childbirth Education, Do No Harm, Evidence Based Medicine, Guest Posts, Healthy Birth Practices, Maternal Quality Improvement, Maternity Care, Medical Interventions, New Research, Newborns, Push for Your Baby , , , , , ,

New Lamaze International Epidural Infographic – Information, Not Judgment

November 4th, 2014 by avatar

Lamaze_EpiduralInfographic_FINALAs a follow up to Henci Goer’s recent analysis of the the Cochrane Systematic Review of the just released epidural study - Early versus late initiation of epidural analgesia for labour,  I wanted to share the newest Lamaze International infographic “Is An Epidural My Only Option?” geared for expectant families.  This fact sheet provides information not only about the epidural, it shares the risks and benefits.  The infographic discusses how to reduce risks and improve outcomes when laboring people choose to use one, such as trying other things first before asking for an epidural and changing positions frequently after the epidural is administered.

Additionally, there are several suggestions for alternatives to an epidural, which some people may find really helps to minimize pain, including using a doula for labor and birth support.  Encouraging families to ask questions about alternatives of their health care providers, choosing a facility that supports alternative forms of pain relief and discussing with their partners how the partner can help them to cope during labor.

I really appreciate the strong encouragement for families to take a Lamaze Childbirth Class in order to learn more about labor and birth and the coping skills that can promote a safe and health birth for mother and baby.  My childbirth classes are chock full of positions, techniques and tips to help reduce pain, maximize comfort and promote normal birth.  We thoroughly cover pain medication options as well, and families leave confident that they can effectively ask for and receive the information they need to make a decision about what, if any, medications they will choose during labor to help with pain.

I invite you to head over and check out the new epidural infographic, consider sharing the print or electronic version and checking out all the wonderful Lamaze resources on the website for educators.  Your students and clients can find the same information on the parent site!

Which infographic is your favorite? Which one do you use and refer to most frequently?  Let us know in the comments section below.

 

Childbirth Education, Medical Interventions, Push for Your Baby , , ,

Q&A with Newly Elected Lamaze International President – Robin Elise Weiss

October 16th, 2014 by avatar

Lamaze International has a new board president and we would like to introduce you to Robin Elise Weiss. I am so delighted that Robin has assumed this role and I am confident that she accomplish great things during her term.

“Childbirth education is one of the most foundational elements of a safe and healthy birth.” – Robin Elise Weiss

© Robin Elise Weiss

© Robin Elise Weiss

Robin Elise Weiss has been elected President of Lamaze International, a nonprofit organization that promotes safe and healthy birth. Weiss is the mother of eight children and brings more than 25 years of expertise in maternal child health and building online communities to her role. She is a PhD candidate, author of more than ten books, and a leading online expert in pregnancy and childbirth. Robin will serve a one-year term beginning in the Fall of 2014.

“Childbirth education is one of the most foundational elements of a safe and healthy birth,” said Weiss. “As president, my goal is to build on the more than 50 years of incredible work and accomplishments of Lamaze by further expanding our capacity to meet parents where they – increasingly – can be found: online. I also want to ensure that Lamaze is addressing the needs of all families, by even further developing our educators both in numbers and diversity.”

In her role as president, Robin will oversee governance of Lamaze International, working with the board and committees to ensure that Lamaze programs and activities continue to fulfill the organization’s mission to advance safe and healthy pregnancy, birth and early parenting through evidence-based education and advocacy.  Robin will be also supporting the Lamaze vision of “knowledgeable parents making informed decisions.”

“Robin is a respected pregnancy and childbirth expert with years of experience as a Lamaze educator teaching both expecting parents and aspiring new educators. She brings natural leadership skills and social media expertise to her new role as Lamaze president,” said Linda Harmon, MPH, and Executive Director of Lamaze International.

Robin received her undergraduate degree in Reproductive Health, and Masters in Public Health from the University of Louisville. She is currently completing her Ph.D. in Public Health Management & Systems Science, also from the University of Louisville. Robin has been an innovator for the past 20 years on the Internet, consistently recognized for her significant role in providing unbiased childbirth education information online, including being the owner and creator of one of the first childbirth websites available.

Weiss is the author of more than ten books including: The Complete Illustrated Pregnancy Companion, The Better Way to Care for Your BabyThe Everything New Mother’s First Year, The Everything Pregnancy Fitness BookThe Better Way to Breastfeed, and The Everything Getting Pregnant Book. She is also the winner of Lamaze International’s prestigious Elisabeth Bing Award for outstanding contribution to childbirth on a national level and the Coalition for Improving Maternity Services (CIMS) Forum Award and the Lamaze International’s Presidents Award for her work with The Birth Survey. Robin lives in Louisville, Kentucky, with her husband and eight children.

I asked Robin a few questions about her thoughts on Lamaze International, her hopes and goals for the organization and some key messages for families and educators.  Join me in learning more about Robin she begins her term as Board President.

Sharon Muza: What are some of the opportunities and challenges that face our organization currently and what plan do you and the board have to meet these challenges?

Robin Elise Weiss: Last spring we had an amazing strategic planning session. I am so excited about all of the opportunities that lay ahead for us, and the fact that we all had similar mindsets about what the biggest challenges were, and a great variety of things to help us combat them. One of the things that we have a plan to address is to help increase the number of educators, in order to increase the number of women we reach with the Lamaze message. As a part of this plan, it’s important that we make that obtainable both as potential educators and as potential class attendants. This means thinking outside of the regular classroom and typical childbirth class attendee.

© Sharon Muza

© Sharon Muza

SM: When you think of the many recent accomplishments of Lamaze International, what are a few that you are most proud of? Why?

REW: One of the many things that Lamaze has worked really hard on is to build a great online presence. We all know what the data says about women’s online habits when it comes to parenting and health. Lamaze has built a great reputation with blogs like Giving Birth With Confidence for the consumer, Science & Sensibility for the educators and birth professional; as well as a variety of other means of simply being there, including Twitter accounts, Pinterest, Facebook, etc. Having ourselves out and about online gives women a chance to see that Lamaze International is an active and vital force, something that they want to have as a part of their birth, thus reaching out to their local Lamaze Certified Childbirth Educator. Being online is something that is huge part of my life, and obviously, I’ve been talking to women in this space for over 20 years. Lamaze is a leader in this area.

I am also really excited about the Push for Your Baby Campaign. It launched last year with the video and has included a series of infographics. These are designed to be quick, evidence based ways for women and families to get information and to help build that faith in Lamaze.

 SM: Why is it more important than ever to pursue and maintain certification as a childbirth educator with Lamaze International?

REW: The push for evidence-based care is one that means that all levels of care, from education to execution of the medical side need to be in sync. As we often see with doctors and midwives, it can be really difficult to stay abreast of the vast amount of information that is published in this field on a daily basis. A certification with Lamaze is the bedrock of an education that is based on evidence, but also strives to continue to increase the knowledge levels and stay up-to-date with science and the changing landscape. Maintaining your Lamaze Certification means that you know that Lamaze is helping you filter out the noise and focus on great content that you need to know to be an amazing educator. We do that in a variety of ways, not the least of which is our Journal of Perinatal Education, Inside Childbirth newsletter, our blogs, and other social media platforms.

SM: What do you believe distinguishes Lamaze International from other childbirth education organizations? For educators? For families?

REW: Lamaze International has set a high bar for the childbirth educator. In 2015, Lamaze turns 55. The changes that have happened in birthing children in the last 55 years are astounding and I am not sure that anyone could have predicted where we would be today. That said, Lamaze has always maintained that a knowledgeable childbirth educator was the cornerstone of helping families prepare for their birth, which certainly hasn’t changed in the past 55 years. But something as basic having a loved one with you when you give birth is taken for granted, that wasn’t always so.

Lamaze International reaches families through the Lamaze Certified Childbirth Educator. This is the gold standard by which all other programs are judged. We are a highly accredited certification and maintenance of that certification. You won’t find a once and done philosophy here. This keeps us on our proverbial toes.

SM: How important do you think it is for Lamaze to sit at the table with and be recognized as a serious player amongst maternal infant health organizations? Do you feel like we are there or do we have some growth in that area?

REW: The good news is that Lamaze does sit at that table and is taken seriously. Certainly there are some organizations that are more likely partners than others, but we are certainly reaching out. Just this past year, I’ve personally seen Lamaze interacting with organizations like DONA International, the American College of Nurse Midwives (ACNM), the American Congress of Obstetricians and Gynecologists (ACOG), and many others. There is always room for growth, and we will continue to reach out where it makes sense. (Don’t forget to mark your calendar for our joint conference in 2015 with the International Childbirth Education Association (ICEA)!)

There has been a large growth in the number of researchers and research that we take part in as an organization. This will continue to grow as we move forward.

SM: How can our members share with the public that this is not your mama’s Lamaze? That our organization and education offerings have moved beyond the stereotypical breathing exercises that seemed our trademark in decades past?

REW: This is one of those places that you need to simply be out there and be visible. Have your elevator speech, or speeches planned. You will get a good feel for what questions are pervasive in your community. You’ll get questions about the breathing. (I like to explain that as an LCCE, my job is to teach a variety of ways to deal with labor, not simply something like breathing, but also being active physically, and involved with your care.) You might get told that they don’t need a childbirth educator for whatever reason. (This is the perfect place to insert what makes you and your class unique! Hello – Talk up the Six Healthy Birth Practices.) Figure out what’s going on in your community and be ready.

You can also be proactive. Get out and talk about Lamaze International and what you are doing locally. Never hesitate to give a quick presentation someplace. (Yes, I’m known for traveling with a baby and pelvis for an impromptu class!) Offer to teach a quick 10 minute class on a topic at the local library (Give them a list of books to have available ahead of time!), or bookstore. Talk to others in your area and support one another, this is even better if you already have a birth network.

And social media and your online presence is also important. Share the links from our blogs and social media, particularly the infographics. These are great to put on your website, send in an email to a potential client, use as books marks, use the social media sharing buttons around the site. Share, share, share!

SM: Tell us something unusual about you that we might never know!

REW: Thanks to social media, I am not sure that I have anything unusual that’s not known. So let me tell you about something of which I am very proud – I was a Military Police Officer in the 101st Airborne Division. Being an MP has been a really unique facet of who I am as a professional and as a mother. I love to explain that I came to birth from a science perspective – the biology, chemistry, and physics – it just all works! What I didn’t understand was the touchy, feely stuff; that was difficult for me to learn. Now I feel like I have just the right amount of everything going for me – the science, the presence, and the sensitive side.

Please join me in congratulating Robin Elise Weiss on her election as board president and offer her good wishes as she begins her year of service in maintaining Lamaze International as the premier childbirth education organization.

 

 

 

Childbirth Education, Lamaze International, Push for Your Baby, Uncategorized , , , ,

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.

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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 , , , , ,