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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 , , , , , ,

Lamaze International Online Classes for Parents Expands Offerings!

November 11th, 2014 by avatar

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The Lamaze International Strategic Framework 2014-2017 that resulted from in-depth strategic planning meetings held earlier this year with the Board of Director and Lamaze Management resulted in many forward thinking, comprehensive and courageous goals, including plans to “innovate education and expand to the childbearing years” by:

  • reaching more women earlier and more frequently throughout childbearing years,
  • expanding delivery methods for online education (e.g., virtual classes, Facetime consults, and mobile apps), and
  • developing a strategy to broaden outreach at the electronic level and cultivate moms ‘up’ the ladder for more personalized services and training.

As part of fulfilling this mission, Lamaze International is pleased to announce that three online childbirth education classes are developed, online and open for business.  The first class to go live was ”Safe and Healthy Birth: Six Simple Steps,” a class designed to help families prepare for birth by presenting six simple practices shown to greatly improve birth outcomes for both mothers and babies. The next two were recently added – VBAC: Informed and Ready and Breastfeeding Basics: From Birth to Back to Work.

The online classes are presented in an interactive, engaging format with unlimited access for parents, so they can complete the class(es) at their own pace. The classes are meant to be used as an important beginning point in a families’ complete prenatal education. They provide vital information, and throughout the online course, families are encouraged to find a comprehensive in person Lamaze class in order receive a thorough preparation for childbirth. Parents are informed that to be fully prepared for labor, birth, breastfeeding, and postpartum, it’s important to attend a good quality childbirth course. There are links to the “Find a Lamaze Class” portion of the parent website.

The online classes can be accessed on a computer (desktop or laptop), tablet or smartphone and learning can take place at a convenient time and place for each individual family.  There are interactive activities and discussion forums to connect with other participating families.  Fun quizzes are spaced throughout the course to help with the retention of information.

Safe and Healthy Birth: Six Simple Steps

Knowledge is power! It’s our goal to help you prepare for one of the most important days of your life – baby’s birthday! This course presents six simple practices that research has shown to greatly improve birth outcomes for both mothers and babies. These practices have been developed by Lamaze International and are based on recommendations by the World Health Organization. Lamaze has simplified the scientific facts into six healthy birth practices to make it easy for you to choose the safest care, understand your options, and steer clear of care practices or unnecessary interventions that may not be the best for you and your baby.

After completing this course, learners will be able to:

  • Discover how the Lamaze Six Healthy Birth Practices can simplify your labor and birth
  • Find out how your care provider and support team can make a difference
  • Learn about common medical interventions
  • Alleviate fears and learn ways to manage pain
  • Build your knowledge and confidence to make informed decisions

Breastfeeding Basics: From Birth to Back to Work

As comforting and healthy as breastfeeding can be, it is not always easy in the first few weeks while recovering from birth. If you find yourself struggling, know that hard work in the early weeks pays off as you and your baby learn to breastfeed. Having realistic expectations about how breastfeeding will go in the early weeks will help you to meet your breastfeeding goals. With the information in this class, you can prepare to get breastfeeding off to a great start and look forward to the many benefits that breastfeeding can provide to you and your baby.

After complete this class, learners will be able to:

  • Recognize the Benefits of Breastfeeding to Mother and Baby
  • Understand how milk supply works
  • Learn about the mechanics of breastfeeding, latch and positioning
  • Recognize good feeding and if baby is getting enough milk
  • Manage nighttime breastfeeding
  • Be prepared for what to do if there is a recommendation to supplement/pump
  • Prepare for returning to work

VBAC: Informed and Ready

This class will help you understand the facts, benefits, and risks of all your delivery options including a vaginal birth after cesarean (VBAC), and set you up for the best chance of success. Prepare yourself and learn how to simplify your labor and birth by participating in this interactive online course.

After completing this class, learners will be able to:

  • Understand the risks and benefits of both VBAC and repeat cesarean birth
  • Recognize the qualities of a VBAC supportive health care provider
  • Identify a strong support team for your  VBAC birth
  • Develop and practice coping and comfort techniques that will help during your VBAC labor
  • Write a VBAC and cesarean birth plan that reflects your informed preferences

International Cesarean Awareness Network (ICAN) has collaborated with Lamaze International to offer all ICAN members a 15% discount on the VBAC class, to help them feel better prepared as they plan for their subsequent birth after a cesarean.  To learn more about ICAN and become a member, in order to take advantage of this discount, follow the link to the “Join ICAN page.”

Additional courses planned include “Labor Pain Management: Techniques for Comfort and Coping” -scheduled to go live next month and an early pregnancy class in the early part of 2015.

Offering online classes serves to increase name recognition of the Lamaze International brand and create demand for in person Lamaze classes offered by LCCEs around the world.  Programs like this position Lamaze as the leader in childbirth education. Additionally, families that do not have Lamaze educators in their community can take advantage of the evidence based information and skills offered in the classes.  Educators can follow the class links above and sample all of the courses in a preview segment.

Breastfeeding, Cesarean Birth, Childbirth Education, Healthy Birth Practices, Lamaze International, Pain Management , , , , , ,

Thank You Midwives! join Lamaze in Celebrating National Midwifery Week!

October 7th, 2014 by avatar

midwifery week poster 2014Please join Lamaze International and Science & Sensibility as we celebrate National Midwifery Week.  Midwives can and should play an integral part of healthy and safe birth practices here in the United States and around the world. Maternal infant health organizations and consumers alike are now aware that we have reached a tipping point.  Our cesarean rate is too high, the availability of VBAC supportive providers is dismal, the rate of inductions, particularly before 39 weeks is cause for concern, labor augmentations are commonplace and infant mortality – particularly amongst babies of color, in our country puts the United States ranking at an embarrassing 56 amongst all the other countries.

The midwifery model of care offers women and babies care by qualified, skilled health care providers who are experts at normal physiologic birth and meeting the needs of healthy, low risk, pregnant women.  The midwifery model of care respects the shared decision making process between the mother and her health care provider, the importance of the mother’s emotional health as well as her physical health and recognizes pregnancy and birth as part of a woman’s normal lifecycle, rather than an illness or pathological condition.  There is respect for the normal physiological process of birth, and the recognition that when things deviate from normal, collaboration and referral to obstetricians and other specialists is appropriate.  When midwives have the opportunity to care for more healthy low risk women, the United States might start to see some of the dismal statistics reverse, and women and babies will benefit from the new trend.

The American College of Nurse Midwives has created a consumer website, Our Moment of Truth, where women can learn more about midwifery, increase awareness and understanding of the different care options available, make informed choices about the type of care they would like to receive and even find a midwife in their area.  There is also a brochure available – “Normal Healthy Childbirth for Women and Families: What You Need to Know” to download in English and Spanish and share with your students and clients. This document and the ACNM program “Our Moment of Truth” was supported and endorsed by Lamaze International along with many other maternal infant health organizations.

The ACNM has a very nice “Essential Facts about Midwives” info sheet that contains some great statistics and information about Certified Nurse Midwives and Certified Midwives.  Midwives can catch babies in hospitals, birth centers and at home and Medicaid reimbursement is mandated for CNMS/CMs in all 50 states.  In 2012, CNMs/CMs attended over 300,000 births in the U.S.  When you add in Certified Professional Midwives/Licensed Midwives who also attend births at birth centers and homes, the number of midwife attended births goes up even further.

ACNM has created a fun video highlighting midwives and the care they provide.  I have also collected of a few of my favorite videos about midwives that you might enjoy viewing and sharing.

Mother of Many from emma lazenby on Vimeo.

What are you doing to celebrate and honor midwives this week?  Do you talk about the midwifery model of care in your childbirth classes and with your doula clients?  What resources do you like using to help your students understand the scope of practice and benefits of working with midwives?  Share with others in our comments below.

Babies, Childbirth Education, Healthy Birth Practices, Home Birth, Midwifery, Newborns , , , , , , ,

World Breastfeeding Week 2014 – Breastfeeding: A Winning Goal for Life

August 5th, 2014 by avatar

wbw2014-logo3August 1-7, 2014 is World Breastfeeding Week and this year’s theme is Breastfeeding: A Winning Goal for Life.  This year’s theme builds upon the Millenium Development Goals (MDGs) developed by the United Nations and global partners.  Breastfeeding plays a critical role in achieving all eight of the MDGs.  The World Alliance for Breastfeeding Action created a dynamic and clear graphic demonstrating how increasing global breastfeeding rates has the ability to impact every single one of the MDGs.

With this in mind, the World Breastfeeding Week theme, “Breastfeeding: A Winning Goal for Life” calls on celebrants to “Protect, Promote and Support Breastfeeding: It is a Vital Life-saving Goal.”  The theme recognizes the critical role that excellent support plays in achieving this goal and childbirth educators are right up there as one of the critical players, as childbirth educators are prepared and qualified to help new families learn about breastfeeding in their childbirth education classes.

Lamaze International supports getting breastfeeding off to a good start with the sixth Healthy Birth Practice: “Keep mother and baby together – It’s best for mother, baby and breastfeeding.”  Your role as a childbirth educator in normalizing breastfeeding, providing prenatal instruction on breastfeeding basics and sharing additional breastfeeding resources for families to utilize after their baby arrives contributes to the Millenium Development Goals with each and every family  you reach.

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Childbirth educators, along with doctors, midwives, labor & delivery nurses, lactation consultants, doulas, and others help support families in reaching their breastfeeding goals, and celebrate breastfeeding with every mother and new family they reach. Breastfeeding is a team effort and everyone plays a critical role.

Have you shared World Breastfeeding Week information with your families that are in your childbirth education classes?  Can you recall the times when a family followed up with you and thanked you for the evidence based information that you provided in their childbirth class, helping them to be prepared to breastfeed their baby after birth. What you do matters every day to mothers and babies and that includes the efforts to share accurate information about breastfeeding and breastfeeding resources with your students.  Thank you, childbirth educators, for making a difference. For more information about World Breastfeeding Week 2014, check out the World Alliance for Breastfeeding Action website.

 

Babies, Breastfeeding, Childbirth Education, Healthy Birth Practices, Lamaze International, Newborns, 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 , , ,