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The Role of the Childbirth Educator during a Perinatal or Infant Loss

October 14th, 2014 by avatar
Original Painting © Johann Heinrich Füssli

Original Painting © Johann Heinrich Füssli

As we continue to observe Pregnancy and Infant Loss Awareness Month, I would like to discuss a difficult topic that may come up for childbirth educators.  Last week, Robin Elise Weiss shared ways to commemorate the loss of a baby. Today, I would like to talk about when a class member experiences a perinatal loss while taking your class, or after the class is over.  If you work long enough as an educator, eventually this will be an issue that you are going to need to face.

Sometimes, you may be contacted by the family, with a somber email or phone call, letting you know that they won’t be returning to class. Other times, a family just stops coming, with no explanation, midway through a series.  You are not sure why.  Was it your teaching style?  Did they have their baby early?  Has something happened?  You will also have to consider that this family may have experienced a late term loss.

When a family does not return to class, I always suggest that the childbirth educator reach out to the family via phone or email to politely inquire and determine that all is okay.  Possibly the mother has been placed on bedrest and will need some accommodations or arrangements in order to complete her childbirth education.  Often, you will find out that something has come up and the date and time no longer work, and you breathe a sigh of relief at this information.  You may find out that their baby arrived prematurely, and you have an opportunity to connect them with resources that they may find useful while dealing with a baby in the NICU and adjusting to the new reality of having a baby weeks or months before they thought they would.  It is likely that their baby may require additional resources and have some immediate needs they had not thought about.  And sometimes, unfortunately, you learn that they have lost their baby either in utero or after birth.

If you are a successful childbirth educator, you work hard to build community in your childbirth classes, helping families to connect with each other through engaging activities and interactive learning.  The families start to see each other as resources and comrades in the transition to parenthood.  Connections are made, friendships are developed and a feeling of community is established.  You are faced with the task of sharing with the class that a family will not be returning.  They are missed and class members usually will be inquiring as to their absence.

When you learn of such a loss, I believe you have several responsibilities as a childbirth educator.  First, determine if the family is open to receiving resources that can help them as they deal with the loss of a baby.  These resources may included peer to peer and facilitated support groups in their community, counselors and therapists specializing in perinatal grief and loss, lactation consultants who can help with the transition of not needing to breastfeed, online resources to help them and more.

If there is a public funeral or memorial service, I make every attempt to attend if possible, in order to show my respect.  Sometimes this is not possible or the family has decided to keep the event private. Regardless,  I always try and promptly send a sympathy card to the family, expressing my sadness at the loss of their son or daughter.

I also politely inquire if they would like me to share the news with the rest of the class.  This information needs to be handled very sensitively.  The family may not want the news shared, and their privacy and wishes are my first priority.  But no doubt, someone in the class will soon ask where the missing family has gone.  In my experiences, the family usually has given me permission to share the information with the rest of the class.  This can be a huge challenge – finding a balance of informing the class and not creating fear and worry for them.

In my experience, the best way to share the information is toward the end of class, with just a few minutes to go.  I respect the family’s wishes and only share the information I have been asked to share.  I tell the truth, but I don’t feel the need to go into great detail.  I answer any questions from the class as best I can and stick to the facts, while respecting the family’s wishes.  If allowed, I provide information about a service or how to contact the family.  I acknowledge that this event is hard to hear, and may bring up concerns and fears for the class members. Sometimes families get very upset or cry as they hear the news.  I provide some resources where they can get more information and support, and also suggest they speak to their health care provider about their fears.  I make myself immediately available after class and in the future to listen to their concerns if they feel the need to connect.

Sometimes a family loses a baby after the class has ended, but before a reunion (if you do class reunions, which are very common here in my area.)  If I am made aware of the loss by the family, I follow the steps above, but ask how they would like me to handle sharing with the class.  I provide this information to those in attendance at the reunion, sharing only information as allowed by the family.

If you have class email lists, or Facebook groups for your childbirth classes, be sure to find out what the parents’ wishes are regarding remaining on the list or in the group.  Some families will want to be removed and others will want to stay connected.  When in doubt, I would discreetly remove them from further communication about class activities, baby announcements or planned gatherings.

Losing a baby during pregnancy or after birth is one of the most difficult things a family can experience.  Our society does not do a great job in honoring this type of loss.  The role of the childbirth educator becomes very important when one of your class members has lost a baby.  How you handle this loss, with both the family and with other class members is critical and can impact the experience of all.  As childbirth educators, we are in a unique position to help both the family and our other students when given permission by the grieving family.

Have you had this experience as a childbirth educator?  How have you handled this situation?  Do you have any tips for other educators in case they have a similar experience?  What did you find worked?  What did you do?  Please share your thoughts and suggestions along with any resources in our comments section.

 

 

 

 

Babies, Childbirth Education, Trauma work , , , ,

You Are Invited to Participate in an Online Learning Opportunity: Patient, Staff, and Family Support Following a Severe Maternal Event

October 10th, 2014 by avatar

council women safety

Past posts on Science & Sensibility – CDC & ACOG Convene Meeting on Maternal Mortality & Maternal Safety in Chicago and U.S. Maternal Mortality Ratio is Dismal, But Changes Underway, and You are Invited to Participate have shared information on the National Partnership for Maternal Safety, a multidisciplinary initiative focused on reducing the rates of maternal morbidity and mortality in the United States.  This partnership falls under the umbrella of The Council on Patient Safety in Women’s Health Care. This unique consortium of organizations across the spectrum of women’s health has come together to promote safe health care for every woman, at every birthing facility in the U.S. through implementation of safety bundles for common obstetric emergencies (hemorrhage, preeclampsia/hypertension and venous thromboembolism) as well as supplemental bundles on Maternal Early Warning Criteria, Facility Review after a Severe Maternal Event, and Patient/Family and Staff Support after a Severe Maternal Event.

The public Safety Action Series has introduced topics including an overview of the Partnership, efforts underway to define and measure Severe Maternal Morbidity, identify and implement Maternal Early Warning Criteria, Quantification of Blood Loss, and the outlines of the OB Hemorrhage Patient Safety Bundle. These slide sets and audio recordings have been archived and are available to the public.

christine morton headshotThe next event will be Tuesday, October 14 at 12:30 pm EST, with presenters Cynthia Chazotte, MD, FACOG, and Christine Morton, PhD, on Patient, Staff, and Family Support Following a Severe Maternal Event, and you can register for the event here. Registering for any event puts you on a list to be informed of upcoming events and future activities of the Partnership. Childbirth educators and other birth professionals may have students and clients who experience a serious medical event during labor and birth.  Having resources for families and for yourself is absolutely critical.  This information will be covered during the online event.

Christine Morton is a board member on the Lamaze international Board of Directors.   We are lucky to have such an active and knowledgeable professional to serve and support the Lamaze mission and values. Please share this information and get involved.

Childbirth Education, Lamaze International, Maternal Mortality, Maternal Quality Improvement, Maternity Care, Pregnancy Complications , , , ,

Ideas for Commemorating Pregnancy and Infant Loss Awareness Month

October 9th, 2014 by avatar

By Robin Elise Weiss, PhDc, MPH, CPH, LCCE

October is Pregnancy and Infant Loss Awareness Month and Lamaze International President Robin Elise Weiss challenges all of us to make some time this month to recognize this somber topic.  Robin provides some creative ideas about how you can honor and remember those families and babies who were separated too soon in your community. – Sharon Muza, Community Manager, Science & Sensibility.

© Vicki Zoller

© Vicki Zoller

October has been identified as Pregnancy and Infant Loss Awareness Month. There are also several other pregnancy and infant groups who have specific memorials and functions that occur this month, but I’m going to focus on this as a general topic.

The beauty of being a Lamaze Certified Childbirth Educator is that I have the joy and pleasure of working with happy pregnant families the vast majority of the time. Though what most people don’t think about when they talk to a Lamaze Childbirth Educator is that we can also be a resource when pregnancy is not going perfectly, and that includes the very devastating death of a baby at any point in pregnancy or as a young baby.

This is not something that most parents-to-be want to hear about. It is something that the vast majority will try to avoid thinking about, even though it is a common fear in pregnancy and beyond. Our job as a Lamaze Childbirth Educator is not to scare them but to give matter of fact, honest information without dwelling on the negative. That said, I know that many childbirth educators do not cover this in childbirth class for a variety of reasons. 

My challenge to you this month is to consider doing any or all of the following, depending on where you are in your journey as an educator, parent, human:

  • Read a Book: There are many good books written about pregnancy loss. The vast majority are written from the view point of the parents involved, but these first hand accounts are extremely poignant and important. It can often be helpful in figuring out how to best help someone who is experiencing the death of their baby. You can also create a reading list of books for parents and one for children. If you can, consider donating a book to your local hospital or library.
  • Take a Class: Often you can find classes available, offered often by hospitals, hospice, or perinatal loss groups, during the month of October. They may be focused on birth workers, or be an in general offering. This is a great way to help build your resource list. One geared towards those who work in birth are going to be your best bet.
  • Take a Tour: Call your local hospital and ask to talk to the Labor & Delivery Nurse Manager. Tell her that you are a Lamaze Certified Childbirth Educator in the area and that you are trying to learn more about how they handle pregnancy loss and stillbirth. Ask if they will share their protocols, and talk to you about local resources. They often support groups that you may not see listed when looking locally.
  • Host a Circle: This can be a very touching but difficult thing to do. I would recommend that you find a local chaplain or counselor to co-host this with you unless you are qualified to handle various issues that may arise. Sometimes this might just be with local birth workers who need to talk about their own losses or the losses within their students or clients.
  • Host a Training: If you have a special talent, consider sharing it with others. For example, many years ago, I learned how to make foot molds and then casts from these molds. I’m the only person in town who does this and that means I go whenever someone asks me to go. There may be times I’m not available, but if I pass that information on to others, then it makes it more available to the community. You could also host a training of other sorts, like having someone come talk to a birth network about how to deal with grief and grieving in class or with your clients.
  • Host a Craft Night: This is something we are trying this year as a way to connect with the labor and delivery nurses on the front lines. A group of local doulas and childbirth educators are meeting at the hospital for a night of knitting and crocheting tiny baby hats to be given to the families who have experienced the death of their baby. It is a way for use to share and work together to make a really horrible experience a bit more personal. We are offering patterns for baby hats from very small gestation sizes through infant sizes, some basic instruction on crochet and knitting, and the hospital is providing a room and snacks.
  • Create Your Own Hats: If you need something to do that is tangible but can’t commit to being with others, you can use the patterns below to create your own stash of hats to donate to your local hospital.

I would invite you to share in the comments what’s on your reading list, other ideas you have for this month or even ideas you have that I may have missed.

Useful Links and Resources

 

 

Babies, Childbirth Education, Guest Posts, Newborns , , , , ,

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 , , , , , , ,

Updated “Birth By The Numbers” – A Valuable Tool for Childbirth Educators and Others

October 2nd, 2014 by avatar

birth by numbers header

One of the highlights of my attendance at the joint Lamaze International/DONA International Confluence in Kansas City, MO last month was the opportunity to hear Eugene Declercq, PhD, present a plenary session entitled “What Listening to Mothers Can Tell Us about the Future Challenges in US Maternity Care.”  Dr. Declercq is a professor of Maternal and Infant Health at Boston University School of Public Health. It is always a true pleasure to listen to Dr Declercq, not only for his delightful Boston accent, but also for the creative and impactful way that he shares data and facts about the state of maternity care, primarily in the United States.

declercq-headshotThis presentation was no exception and Dr. Declercq helped conference attendees to tease apart the information gleaned from the most recent Listening to Mothers III study, and look at this information  in relationship to data from the two previous Listening to Mothers studies.

Dr. Declercq reminded those of us in the audience that the most recent update of “Birth by the Numbers” was just made available on the Birth by the Numbers website.  I am a huge fan of the previous versions of this short film, that highlighted statistics on how the United States is doing on several key maternal and infant indicators in relation to other nations around the world.  The information continues to be both eye opening and sobering at the same time.  I encourage you to view the most recent edition included here.

I have seen Teri Shilling, the director of Passion for Birth, one of the Lamaze Accredited Childbirth Educator Programs, use the Birth by the Numbers video in a very clever way when training both doulas and childbirth educators.  This learning activity could also be adapted to use in your childbirth class.  Teri provides a worksheet with many of the important statistics that Dr. Declercq shares in his video, listed out.  The learner must watch the video and assign the correct definition to each relevant number listed.  It helps the viewer to really capture the significance of the different numbers, when they are closely listening for each one and then the video can be debriefed as a group.

Dr. Declercq’s website has tons of useful information that you can take into the classroom.  I subscribe to/follow the blog on his website and look forward to new articles when they come out.   Dr. Declercq also generously shares PowerPoint slides on both the “Birth by the Numbers” presentation as well as “Cesarean Birth Trends” that educators can freely use in their own classroom.

Should you be interested in maps and details on the cesarean birth trends for several other countries, including Australia, Brazil and Germany, that information is provided along with a state by state breakdown.

You can also find the updated Birth by the Numbers video on the Lamaze websites for professionals and for parents.

If you have not seen them, I also really enjoy Dr. Declercq’s  videos “The Truth about C-Sections” and “Debunking the Myth: Home Births are Dangerous” published in cooperation with Mothers Naturally

One last fun fact – did you know that Dr. Gene Declercq is a Lamaze Certified Childbirth Educator!   Thanks Dr. Declercq for all you do to get solid data to all of us in fun and informative ways.  I appreciate it.

A challenge for you! How might you use the information in the updated video and on the Birth by the Numbers website in your childbirth class, with doula clients or with the patients you care for?  Do you have any teaching ideas that you would like to share with Science & Sensibility readers?  I would love to hear your creative ideas and I know others would too.  Sharing teaching tips helps all of us become better educators.

 

 

2014 Confluence, Cesarean Birth, Childbirth Education, Films about Childbirth, Lamaze International, Maternal Mortality, Maternal Mortality Rate, Maternal Quality Improvement, New Research, Research , , , ,