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Happy 100th Birthday, Elisabeth Bing – Lamaze Co-Founder and Visionary Leader

July 8th, 2014 by avatar

By Dr. Mary Jo Podgurski

“If I have seen further it is by standing on the shoulders of giants.”  Sir Isaac Newton, Letter to Robert Hooke, February 5, 1675

The co-founder of Lamaze International (known first as ASPO/Lamaze), Elisabeth Bing, turns 100 years old today.  Elisabeth was a leader and advocate for mothers, babies and families long before this type of advocacy had a name.  Dr. Mary Jo Podgurski, past president of Lamaze International and long time friend and colleague of Elisabeth’s, shares some thoughts on this forward thinking woman who cared enough to take action, become a leader and then create an organization that has helped millions of families over the years achieve a safe and healthy birth.  We salute you Ms. Bing and thank you deeply! – Sharon Muza, Science & Sensibility Community Manager.

Ms. Bing and babyMs. Bing and babyMs. Bing and babyWhen Elisabeth Bing first encountered childbearing women in the London of her twenties, she was a physical therapist with an assignment that sounds alien in 2014. Postpartum women were confined to bed for 10 days, without the ability to even put their feet on the floor! Physical therapists provided exercise and massage. The creativity, drive and passion Elisabeth demonstrated in the 40s and 50s became the foundation for the Lamaze method of childbirth education that is internationally taught and respected today.

Elisabeth’s memoir, My Life In Birth, details her journey from Nazi Germany to America, and provides insight into her many years of service to pregnant women. Giving birth between the 1930s and 1960s meant a woman had few if any choices about the way her baby was born. Mentally disoriented by “twilight sleep” and strapped down for “delivery” lest the sterile field be disrupted, a childbearing woman then was more a vessel for the baby than an active participant. In time women demanded an active role in the birth of their babies. Elisabeth was on the cutting edge of change. With Marjorie Karmel, author of Thank You, Dr. Lamaze, she was a revolutionary with the vision to see a consumer movement poised to create a very real difference in the way women gave birth. Elisabeth was the catalyst for that movement.

1996

1996

When I first spent a weekend with Elisabeth in her New York apartment, she was entering her eighties but was still teaching childbirth education twice a week. Her studio was perfect. Baby pictures were prominently displayed, childbirth posters lined the walls, and the atmosphere was relaxed, comforting and empowering. When asked, Elisabeth explained that pregnant women’s concerns were unchanged. Yes, she told me, the climate in hospitals had changed. Now Lamaze classes were common but medical interventions like epidurals continued to disrupt normal, natural birth. The obstacles were altered but the need for informed choices was ongoing. Women, Elisabeth said, still needed the truth.

Teaching 1978

Teaching 1978

Elisabeth turns 100 today, July 8, 2014. Consider her amazing reach. I am one small piece of her heritage. I’ve been honored to personally learn from this amazing, dynamic mentor for nearly 25 years. Her book, Six Practical Lessons for an Easier Childbirth, was my bible as I approached my first birth in 1976. That baby, my daughter Amy Podgurski Gough, is also a certified Lamaze childbirth educator. Between the joy of my first birthing experience and the births of Amy’s three babies, I’ve been blessed to teach thousands of women and their partners. Like most childbirth educators, I am deeply in Elisabeth’s debt.

Much has been written about Elisabeth’s contribution to childbirth education. A facet of her personality seldom discussed, however, is her insight surrounding collaboration. Her initial work in co-founding ASPO/Lamaze (now Lamaze International) in 1960 created a not-for-profit organization composed of parents, childbirth educators, health care providers and other health professionals. From the start, she discovered the strength of working with a group of people as opposed to standing alone. During the last keynote presentation Elisabeth presented at a Lamaze International national conference, I listened, mesmerized, as she prophetically discussed the need to talk with “insurance companies” as a way to continue her dream of teaching as many women as possible. Her commitment to excellence, to advocacy, and to childbearing women and their partners remains fierce in spite of the passage of time.

1982 ASPO/Lamaze Conference

1982 ASPO/Lamaze Conference

Elisabeth has been called the “mother of childbirth education” and she deserves that title. Her legacy guides all childbirth educators. When I picture her, I envision a physically tiny women with a spirit so powerful one forgets her stature. I look into her clear, bright eyes and see her pure white hair, pulled back into a pony tail with a blue ribbon. I sit in her kitchen sipping tea and drinking in her intelligence. Her cat purrs at our feet. My daughter Lisa is across the table, equally transfixed. I lean in, anxious to remember every moment of this encounter. She smiles, and her eyes light with purpose. I share my personal plans for starting a teen outreach. Elisabeth listens deeply, then offers advice I still adhere to twenty years later.

Elisabeth is an icon, a woman of vision and our true mother. To me she is a dear, precious friend. On July 8th, I will travel to New York City and enter her kitchen again, cognizant of the immense gift Elisabeth’s life has been to all who care about women, birth, and the future. One cannot measure her full worth; I know her wisdom echoes in the mission of every childbirth educator who follows in her footsteps. Thank you, Elisabeth!

© ospreyobserver.com

© ospreyobserver.com

Science & Sensibility and Lamaze International would like to let Elisabeth Bing know what a great organization she created, and how it has impacted so many.  Please leave some wishes for a happy birthday in our comments section and if you wish, share what Lamaze means to you (as an educator, a birth professional, a mother, a father, or a health care provider).  Lamaze International will make sure that every wish is printed and sent on to Elisabeth for her to enjoy!  That will certainly touch her heart!  Please, leave your wishes, stories and memories below. – SM

About Dr. Mary Jo Podgurski

MARY JO PODGURSKIDr. Mary Jo Podgurski is the Director of The Washington Health System Teen Outreach and President and Founder of the Academy for Adolescent Health, Inc. Her undergraduate education is in nursing and education, her master’s work was in counseling, and her doctorate is in education. She began volunteering with pregnant teens in the 70s and has created numerous youth development and education programs using reality-based, interactive educational techniques that are evidence-based and empower youth.

Dr. Podgurski became interested in child abuse prevention as a way to lower teen pregnancy and authored the book Inside Out: Your Body is Amazing Inside and Out and Belongs Only to You, and runs a body-positive, child-centered, interactive, child abuse prevention program.

Dr. Podgurski has presented over 500 workshops locally, nationally and internationally.  She is proud to be an adjunct faculty member in the Education Department of Washington and Jefferson College where she created and teaches the course: Teaching and Dealing with Sexuality in Schools in 2010.

Dr. Podgurski’s certifications include LCCE and FACCE (Fellow in the College of Childbirth Educators) from Lamaze International as a certification as both a sexuality educator and a sexuality counselor from AASECT (American Association of Sexuality Educators, Counselors and Therapists), certification through Parents as Teachers, and certification as a trainer in the Olweus Bullying Prevention Program. She is a past president of the Lamaze International Board of Directors.

Dr. Podgurski has received numerous awards, including the UPMC Dignity and Respect Champion Award in 2011, the Three Rivers Community Foundation Social Justice Award and the Washington County Children and Youth Champion for Children Award in 2009. She was the 2008 Washington County NAACP Human Rights Award recipient and the 2004 Washington County recipient of the Athena Women of Wisdom Award. She was awarded the 2004 NOAPPP (National Organization on Adolescent Pregnancy, Prevention and Parenting, now Healthy Teen Network) Outstanding Professional Award. In May of 2014 she was inducted into the Washington County Historical Society’s Washington County Hall of Fame for her contributions to the community through education of family planning and adolescent health.

Mary Jo and her partner Richard are the parents of three adult children and are blessed with three grandchildren.

Babies, Childbirth Education, Guest Posts, Lamaze International, Lamaze Method, Lamaze News , , , ,

The Red/Purple Line: An Alternate Method For Assessing Cervical Dilation Using Visual Cues

July 3rd, 2014 by avatar

By Mindy Cockeram, LCCE

Today’s blog post is a repost of one of the most popular posts ever shared on our blog. It is written by Mindy Cockeram, LCCE.  Mindy explores the “mystical” red/purple line that has been observed to provide information about cervical dilation without the need for a vaginal exam. Have you seen such a line.  Do you have other ways of identifying dilation that do not involve cervical exams?  Please share in the comments- Sharon Muza, Science & Sensibility Community Manager.

When couples in my classes are learning techniques for coping in labor, such as the Sacral Rub (sacrum counterpressure), Double Hip Squeeze and Bladder32 accupressure points,  I always talk about the great position the partner is in for spotting the red, purple or dark line (depending on skin color) that creeps up between the laboring woman’s buttocks and how – by ‘reading’ that line – he or she may be able to assess more accurately the woman’s cervical progress than the health care providers!  This empowering thought is often met with smiles and laughter especially when I translate ‘natal cleft’ into more recognizable words like ‘butt cleavage’.  Strangely, I’ve never had anyone in class mention having heard of this ‘thermometer’ for accessing cervical dilation by sight and I find this interesting considering the number of medical professionals that come through my classes.

Photo CC http://www.flickr.com/photos/alexyra/214829536/

I first came across this body of research as an Antenatal Student Teacher with the National Childbirth Trust in London.  The article I was reading was in Practising Midwife and was a ‘look back’ at the original article (Hobbs, 1998) published in the same magazine.  The original Practising Midwife article was based on a letter referencing a small study by Byrne DL & Edmonds DK published in The Lancet in 1990.

In the 1990 letter to The Lancet, Byrne and Edmonds outlined and graphed 102 observations from eighteen midwifes on 48 laboring women. It states “The red line was seen on 91 (89%) occasions, and was completely absent in five (10.4%) women and initially absent in three (6.25%).”  The report then goes on to talk about the “significant correlation between the station of the fetal head and the red line length.”  Later the authors write: “To our knowledge, this is the first report of this red line.  We believe that it represents a clinical sign which is easy to recognize and which may offer valuable information in obstetric management.”

So how does this line work?  And why does this it appear?  Practising Midwife Magazine presented a graphic which I have attempted to recreate here.  Basically as the baby descends, a red/purplish (or perhaps brown depending on skin color) line creeps up from the anus to the top of the natal cleft in between the bottom cheeks.  When the line reaches the top of the natal cleft, 2nd stage is probably a matter of minutes away.  A line sitting an inch below the natal cleft is probably in transition.  A line just above the anus probably signifies early labor.

Byrne DL & Edmonds DK, the authors of the original study, surmise that the cause of the line is “vasocongestion at the base of the sacrum.” Furthermore, the authors reason that “this congestion possibly occurs because of increasing intrapelvic pressure as the fetal head descends, which would account for the correlation between station of the fetal head and red line length.”  Fascinating and logical!

Interestingly, I came across a 2nd Scottish study from 2010 published by BMC Pregnancy & Childbirth: (Shepherd A, Cheyne H, Kennedy S, McIntosh C, Styles M & Niven C) which aimed to assess the  percentage of women in which a line appeared (76%. ) The study cited only 48-56% accuracy of vaginal examinations to determine cervix diameter and fetal station.  So why aren’t clinicians using this less invasive visual measure – especially considering how much some women may dread vaginal exams in labor??  Wouldn’t the thought of using a methodology to lower infection rate after rupture of membranes has occurred enthuse Health Care Providers instead of using higher risk techniques?  Or how about using the accuracy of the line at the natal cleft to know when a women using epidural should really be coached to push?

My educated guess is that this information has not yet reached Medical Textbooks and non-standard practices can take years to become mainstream (for example. delayed cord clamping) – and then only if or when women request them or media sensation activates them.  In addition, since laboring women are only intermittently attended by Labor & Delivery staff during early and active labor and often encouraged to “stay in bed,” Health Care Providers aren’t necessarily faced with a woman’s buttocks in labor.  Also vaginal examinations are considered “accurate” so staff have no need to peek between a woman’s natal cleft.   However both these studies, paired with the roughly 50% accuracy rate of manual vaginal exams, show that there is potentially a more accurate and less invasive way ahead.

In The Practising Midwife (Jan 2007, Vol 10 no 1, pg 27), Lesley Hobbs writes “Accurate reading would seem to the key to this practice.  I sometimes notice in myself a wish to see the line progressing more quickly than it actually does; when I do this – and check with a vaginal exam – only to find the line is right, I get annoyed with myself and wish I’d trusted my observations.”  Later she goes on to say “I can now envisage a time when I shall feel confident enough to use this as my formal measurement mechanism and abandon intrusive and superfluous vaginal exams.”

Licensed Midwife Karen Baker from Yucaipa, CA commented “The purple line is a curious thing.  It’s definitely not present on everybody but is more prominent on some than others – especially right before pushing.  It tells us when she’s in full swing if we are in a good position to spot it!”

I often urge couples to send me a picture of the so called ‘purple line’ which I promise I will use only for educational purposes but so far a picture is as elusive as the Loch Ness Monster.  So, as I say in class, ‘show me your purple line’!

Are you a midwife, doctor, nurse or doula who has observed this in a client or patient? Partners, have you seen this when your partner was in labor? Has anyone heard of it or witnessed it?  If you are a childbirth educator, do you feel this is something that you might mention in your classes?  Do you think that the families in your classes might be likely to ask for this type of assessment if they knew about it? Please comment and share your experiences.

References

Byrne DL, Edmonds DK. 1990, Clinical method for evaluating progress in first stage labour.Lancet. 1990 Jan 13;335(8681):122.

Downe S, Gyte GML, Dahlen HG, Singata M. Routine vaginal examinations for assessing progress of labour to improve outcomes for women and babies at term (Protocol). Cochrane Database of Systematic Reviews 2012, Issue 9. Art. No.: CD010088. DOI: 10.1002/14651858.CD010088.

Hobbs 1998. Assessing cervical dilatation without Vaginal Exams. Watching the purple line. The Practising Midwife 1(11):34-5.

About Mindy Cockeram

Mindy Cockeram is a Lamaze Certified Childbirth Educator teaching for a large network of hospitals in Southern California.  She has a BA in Communications from Villanova University and qualified as an Antenatal Teacher through the United Kingdom’s National Childbirth Trust (NCT) in 2006.  A native of the Philadelphia area, she spent 20 years in London before relocating to Redlands, CA in 2010.

 

 

 

 

Childbirth Education, Guest Posts, Midwifery, New Research , , , , ,

A Celebration of Midwifery – Supporting Safe, Healthy Birth!

July 1st, 2014 by avatar

In June, midwives were making news all around the world in person and in print.   Maternity care researcher Judith Lothian presented at the International Congress of Midwives conference in Prague, an enormous international gathering of thousands of midwives from all the corners of the globe that occurs every three years. Dr. Lothian shares her impressions of the Congress gathering today.  Additionally, the journal, The Lancet released its Series on Midwifery, long awaited and recognizing that if normal, safe birth is to be supported, midwifery care is the key to achieving that goal.  Dr Lothian summarizes this important series and shares what it means for women and their babies. – Sharon Muza, Community Manager, Science & Sensibility

@ Barbara Harper

@ Barbara Harper

In the US, where midwives attend around 10% of births and around 1% of women have planned out of hospital births, most women and many health care providers know little, if anything, about midwifery. Several decades ago, I began to write about midwifery and out of hospital birth as a way of promoting, protecting and supporting normal birth.  More recently, I’ve done research on women’s and midwives’ experiences of home birth. I’ve also spent a great deal of time with midwives, with my daughters during the births of my grandchildren, at two historic Home Birth Summits, at Normal Birth conferences and, in the last 2 years working with the American College of Nurse Midwives on their Normal Birth Initiative. I count many midwives among my most respected and cherished friends.

I’ve wanted to spread the good news about midwifery and women and babies for a very long time, but the last month has me wanting to ring bells, light candles, and shout from the rooftops to celebrate the tremendous accomplishments of midwives and midwifery, the courage of midwives, and the commitment of midwifery to women and children here in the United States and across the globe.

In early June I attended the International Congress of Midwives in Prague. Thirty eight hundred midwives (and a smaller group of nurses, sociologists, epidemiologists, birth advocates and researchers) came together as they do every three years to share what they know, learn what they don’t know, and recommit themselves to women and babies around the world.  Midwives from 85 countries, most often in the traditional dress of their country, paraded into the opening ceremony. The video and pictures from this event can’t begin to capture what it was like to be there, but it does give you a taste of the excitement and the pride.  It was truly amazing.

ICM.Frances_open

@ Barbara Harper

The number of sessions was mind boggling. In each time slot there were multiple sessions on normal birth. It was difficult to choose and impossible to get to even a small percentage of what was offered. I am sharing some of the standouts for me.

Lisa Kane Low, from the University of Michigan, and a champion of midwifery and evidence based maternity care, was a plenary speaker. Her talk on access to care highlighted the importance of meeting women where they are and putting their needs, not ours, first. Toyin Saraki is the newly appointed ICM Global Goodwill Ambassador. The former First Lady of Nigeria, she is the founder and director of the Wellbeing Foundation Africa. The work of the foundation has reduced maternal mortality in Nigeria by 20%.

Ms. Saraki shared a Nigerian saying with us: If you want to go fast, go alone. If you want to go far, go together.  I can’t stop thinking about that, and its implications for our work.  Cecily Begley, the Chair of Nursing and Midwifery at Trinity College Dublin, participated in a plenary panel, Education: The Bridge to Midwifery and Women’s Autonomy. Professor Begley talked about “communities of change” and she described education and research as necessary in crossing the bridge to change. Ray DeVries and Saras Vedam participated in a symposium on ethics related to birth place. Both Ray and Saras contributed to the Journal of Clinical Ethics Fall 2013 special issue on place of birth. The audience participation was lively.

© Barbara Harper

© Barbara Harper

The ethical issues related to pushing women to unassisted births when there is no real choice related to planned, assisted out of hospital birth and the ethical issues of hospitals and providers stonewalling efforts to make transfer seamless, safe, and without recrimination were discussed. Dr. Marianne Nieuwenhuijze from the Netherlands, presented her excellent work on shared decision making. Tanya Tanner from ACNMEllie Daniels from National Association of Certified Professional Midwives, and I presented the collaborative work of ACNM, MANA and NACPM developing a consensus statement on normal, physiologic birth, and more specifically, our work developing a consumer statement based on the consensus statement, Normal, Healthy Childbirth for Women and Families: What You Need to Know.

It was wonderful meeting midwives from Australia, Canada, Ghana, the UK, and Ireland. The challenges are not exactly the same as ours in the US, but we are all fighting uphill battles in support of normal birth.

On the heels of the ICM, The Lancet launched its eagerly awaited Lancet Series on Midwifery.  In Ireland for the summer, I was glued to my computer savoring every moment of the launch online on June 23.    The lead author of each of the four major papers provided a summary and there were comments from a wide array of noted scholars, researchers, practitioners and policy makers from around the world. There were many familiar faces from the International Congress of Midwives. Toyin Saraki gave a stirring speech applauding midwifery, noting that midwifery is not a job, but a passion, a vocation.  Holly Kennedy, who co-authored a paper, and is working on a follow up paper, brought congratulations from the ACNM.

Why did the Lancet do a series on midwifery? Richard Horton, who was involved in the project from the beginning , has this to say in his commentary, The Power of Midwifery:

“Midwifery is commonly misunderstood. The Series of four papers and five Comments we publish today sets out to correct that misunderstanding. One important conclusion is that application of the evidence presented in this Series could avert more than 80% of maternal and newborn deaths including stillbirths. Midwifery therefore has a pivotal, yet widely neglected, part to play in accelerating progress to end preventable mortality of women and children”.  Horton and Astudillo  go on to note that the work is based on a set of values and philosophy that are distinctive. “These values include respect, communication, community knowledge and understanding, and care tailored to a woman’s circumstances and needs. The philosophy is equally important—to optimise the normal biological, psychological, social, and cultural processes of childbirth, reducing the use of interventions to a minimum. “

The four papers include

  • Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care by Mary J Renfrew, Alison McFadden, Maria Helena Bastos, James Campbell, Andrew Amos Channon, Ngai Fen Cheung, Deborah Rachel Audebert Delage Silva, Soo Downe, Holly Powell Kennedy, Address Malata, Felicia McCormick, Laura Wick, Eugene Declercq
  • The projected effect of scaling up midwifery by Caroline S E Homer, Ingrid K Friberg, Marcos Augusto Bastos Dias, Petra ten Hoope-Bender, Jane Sandall, Anna Maria Speciale, Linda A Bartlett
  • Country experience with strengthening of health systems and deployment of midwives in countries with high maternal mortality by Wim Van Lerberghe, Zoe Matthews, Endang Achadi, Chiara Ancona, James Campbell, Amos Channon, Luc de Bernis, Vincent De Brouwere, Vincent Fauveau, Helga Fogstad, Marge Koblinsky, Jerker Liljestrand, Abdelhay Mechbal, Susan F Murray, Tung Rathavay, Helen Rehr, Fabienne Richard, Petra ten Hoope-Bender, Sabera Turkmani
  • Improvement of maternal and newborn health through midwifery by Petra ten Hoope-Bender, Luc de Bernis, James Campbell, Soo Downe, Vincent Fauveau, Helga Fogstad, Caroline S E Homer, Holly Powell Kennedy, Zoe Matthews, Alison McFadden, Mary J Renfrew, Wim Van Lerberghe

The Lancet Series on Midwifery makes a major contribution to the literature bringing together the evidence basis for midwifery, its outcomes, and how to affect policy. We need to translate that evidence into action, into the education of the women we teach, and into our advocacy efforts on behalf of safe, healthy birth.

The Lancet Series on  Midwifery can be accessed at through this link. The series includes an executive summary, commentaries, and the four major papers. You need to register on the Lancet site but everything can be accessed for free.

The time has come to recognize and celebrate the incredible work that midwives do. In the US, it is time for women to know about midwifery, and to see the connection of midwifery and normal, physiologic birth.  It is time for childbirth educators to encourage women to choose midwifery care, and time to collaborate with midwives both in our communities and on organizational and governmental levels.  If we want to promote safe, healthy, normal physiologic birth, we need to promote and support midwifery. Healthy low risk women need to know that if they want the safest, healthiest birth for themselves and their babies that they need to find a midwife.

About Judith Lothian

@ Judith Lothian

@ Judith Lothian

Judith Lothian, PhD, RN, LCCE, FACCE is a nurse and childbirth educator. She is an Associate Professor at the College of Nursing, Seton Hall University and the current Chairperson of the Lamaze Certification Council Governing Body. Judith is also the Associate Editor of the Journal of Perinatal Education and writes a regular column for the journal. Judith is the co-author of The Official Lamaze Guide: Giving Birth with Confidence. Her research focus is planned home birth and her most recent publication is Being Safe: Making the Decision to Have a Planned Home Birth in the US published in the Journal of Clinical Ethics (Fall 2013).

Evidence Based Medicine, Guest Posts, Home Birth, Maternal Quality Improvement, Maternity Care, Midwifery , , , , , , ,

5 Business Practices of Successful Childbirth Educators

June 26th, 2014 by avatar

by Robin Elise Weiss, PhDc, MPH, LCCE, FACCE

Robin Weiss, childbirth educator and president-elect of Lamaze International shares some very smart business tips for being a successful childbirth educator, regardless of whether you work for a large hospital system or teach independent classes. Check out her advice below and share your own suggestions in our comments section. – Sharon Muza, Community Manager for Science & Sensibility

Being in childbirth education is an amazing profession. As a childbirth educator, we are privileged to be with families as they learn and prepare for one of the most exciting journeys of their lives, that of giving birth. Many childbirth educators began this path as a calling, and have had to stumble through the business aspects. It can be difficult to separate the calling from the business.

The good news is that there are five things that you can do that will greatly improve your business acumen and help you become successful in all facets of your profession.

1) Get educated

A formal education in childbirth prepares you to teach and for your certification examinations. However, other than quick mentions of finding clients and paperwork, there is often little information given towards having a business and running it well. There are many questions that you might have from settling on a business name, incorporating, taxes, license fees, or office space. These are questions that have widely varying answers, but that are very specific to where you live and how you practice. Finding a local resource for education is an imperative. Many groups that are willing to help small business owners, like SCORE. They offer free classes and counseling to help you get started.

2) Have back up

Back up in this case refers to your certifying organization. Having an international organization behind you will open many doors. While a hospital of doctor’s office may not know you, the name of an organization such as Lamaze International is well known. The people that you are applying to work with know of the high standards that Lamaze International sets forward in their educators.
There are also special benefits to being a member of a professional organization. This can include referrals for clients in your area, continuing education, conferences, and other things of professional interest. In addition to these benefits, there is also the satisfaction of being with like-minded people.

3) Give Referrals

Referrals may seem like something that does not fit in this list. But following the old adage of it being better to give than to receive is only partially true. I would amend it to be that when you give, you also receive. Keep a local resource list handy and feel free to give it away to anyone who would like it. Also be quick with personal referrals for those with complementary business practices. Think about lactation consultants, doulas, midwives, and doctors in your area. Be sure to ask the person to whom you give the referral to say that you sent them. This shows others in the area that you appreciate their services. Consider asking for their cards to pass out when asked for referrals.

4) Be present

Attend all of the local functions that you are invited to attend or that you can apply to attend. This can include baby fairs thrown by hospitals, guest speaking for various groups from nursing education to mothers’ groups. Being seen in public and having lots of people get to know you is beneficial. It has two benefits, 1) to get to know others in the community and to give back, and 2) to let people know about your services.

5) Be prepared

You should always be prepared with at least two things: your business cards and your elevator speech. Multiple business cards is a no brainer. Don’t be so thrilled with your cards that you are afraid to give them out. (I did this when I first started!) Give them out like candy. Need to give another mom your number for a play date? The back of your card works as a great white space!
Your elevator speech is a 1-2 minute long summary of what you do. Be prepared so that the next time someone asks you what you do for a living, you can quickly and confidently tell them. You can practice this after writing it out at home if that helps you. Some childbirth educators say that they’ve even made a video to watch themselves give this mini-speech to help make it more natural.

In the end, do not let the business side of your calling be a barrier. There are ways to build this side of your skill set and to be both a great childbirth educator and a great businessperson, with just a few steps.

About Robin Weiss

robin weiss head shotRobin Elise Weiss is a childbirth educator in Louisville, KY. She is also the President-Elect of Lamaze International. You can find her at pregnancy.about.com and robineliseweiss.com

Childbirth Education, Continuing Education, Guest Posts, Lamaze International , , ,

Series: Welcoming All Families – The Need for LGBTQ- Specific Childbirth Classes

June 24th, 2014 by avatar

By Kristin Kali, LM, CPM

© Kendra Quinn

© Kendra Quinn

Today on Science & Sensibility, as part of the occasional series, Welcoming All Families, midwife and educator Kristin Kali, LM, CPM shares information on holding a childbirth class that is designed specifically for LGBTQ families.  Kristin discusses the benefits of holding an LGBTQ class, provides some resources and offers additional information on content designed to meet the specific needs of LGBTQ families.  - Sharon Muza, Community Manager, Science & Sensibility

Take off your childbirth educator hat for a moment, and consider your own personal experience. If you are a member of a culturally marginalized group, (and if you do not identify as a member of a marginalized group – imagine) you know the difference between being in a space where you are welcomed and respected, versus being in a space with others who share a similar cultural experience, who speak a common language, and who have aspects of everyday life in common. In a space that is welcoming yet mixed, you may only discuss things you hold in common with those around you, unless you are willing to teach others around you in order for them to understand you and your experience. But if you are in a position of vulnerability, such as being pregnant, or in a class to prepare you for giving birth, you are not likely to discuss things that the people around you simply do not understand or do not have a context for.

Imagine being a lesbian, gay, bisexual, transgender or queer person who is going through pregnancy, with many of the same physiological concerns as any pregnant person, and with many of the same needs and desires, including the desire for a healthy baby, a positive birth experience, and a childbirth class to help assist in attaining that goal. Yet, although you have much in common, if you are in a class of primarily heterosexual couples, or even a class with many different types of families, some of the primary aspects of your experience of bringing this baby into the world and becoming a parent will not be shared.

© Firestone-Kahn 2013

© Firestone-Kahn 2013

Now put your childbirth educator hat back on again. As a childbirth educator, you might be thinking, “Well, there are many unique circumstances that people have when they come to a childbirth class – people may be coming from having dealt with infertility, military wives whose husbands are away at war, women who are giving birth as single moms. We are together to learn about giving birth, so that’s mostly what we talk about when the group comes together.” I invite childbirth educators to imagine any one of those unique scenarios, and envision if the class was full of people who had that scenario in common. How powerful would that be? What might be discussed in the safety of others who truly understand this experience? How might that affect the empowerment, strength and resolve of someone who is preparing for the prospect of giving birth and becoming a parent?

I can tell you, after 9 years of teaching specialized childbirth classes for LGBTQ families, that it is very powerful. When people live in a culture where their relationship may not be honored with the right to marry, when a child is born and a parent is not legally recognized as a parent and they have to prove themselves worthy to a social worker just to gain legal parentage (or perhaps legal parentage is not allowed in their state at all), when they didn’t simply have sex with their partner, rather they used all of their savings and maxed their credit cards just to get the funds for sperm so that they could conceive, it is such a relief to be in a group that has the same common denominator. More than that, it allows for camaraderie, and issues that are unique to families like theirs to be discussed.

In my childbirth classes, the families introduce themselves to each other with the “usual” information, such as name, due date and place of birth. However, before we get started with introductions, I briefly talk about the transformation of self that happens when a person becomes a parent, and as a person’s gender is so central to who they are, of course gender is central to that experience. I invite the introductions to include stating the pronoun that they prefer people to use in reference to them, and also what they plan for their baby to call them – maybe Mom or Dad, but perhaps a different word that more closely matches their gender such as Baba or Dadmom or anything else.

The second thing we do is share conception stories – I’ll bet this is not something discussed in heterosexual or mixed groups! But for the LGBTQ families in my class, the pregnancy experience started way before that little one was growing inside, and sharing these stories candidly establishes normalcy when the situation is not viewed as “the usual way” by society. Furthermore, families may be still be carrying emotional aspects of their conception process in a way that can impact the birth itself, or the partnership during the transition to new parenthood. Sharing conception stories brings me, as the instructor, up to date. It lets me know what happened for each family in the process of getting to this class, and anything important that I need to watch out for or hold space for with each parent-to-be.

Throughout the class, after setting the stage for open discussion and creating such a sense of safety, participants are likely to ask the important questions that they may not otherwise have asked. People feel free to be exactly who they are, not a guarded sense of “how much can I share about myself and not have the other parents look at me weird or be a spectacle”. We cover all the aspects of labor and birth that would be covered in any childbirth class. In fact, my class is based on a popular curriculum. I just bring together LGBTQ families and specifically discuss topics that are unique to this group within the context of the curriculum.

What makes an LGBTQ childbirth ed class so special? I will let the parents speak for themselves by sharing some of the feedback and comments I have received after class:

“There is something wonderfully supportive about being surrounded by other queer families. It created a truly safe and inclusive space where our LGBT experience was at the center, and not just touched on as an aside or an exception to the norm.”

“I am so grateful for this class. Going in as a queer family, not having to translate from everyone else’s ‘normal,’ not needing to explain our family was great.”

“As a gender variant pregnant woman, this class provided support and community that is often lacking in society at large.”

“I needed to voice fears and have time to ask questions in a non-judgmental space.”

“It’s not just about using neutral pronouns and terms (like “birth parent” instead of “mom”). It’s  great to be in a room full of queer folks who understand my experience, so I feel like my queer specific questions are adding to the group’s experience rather than distracting or pulling the class off on a tangent.”

As an educator, it is important to be able to inform people about what to expect, and to be able to hold people as they explore their thoughts and feelings in relation to the class material. While LGBTQ families may have a lot in common, each family is unique. There is a broad range of family structures, conception histories, gender issues, co-parenting strategies, and interpersonal dynamics to explore, all in relation to giving birth and caring for a newborn.

For those who are interested in teaching childbirth classes for LGBTQ families, there are a number of considerations. Are there enough families in your community to support an exclusive class? Even if you are an LGBTQ person, do you have experience working with a variety of LGBTQ people in the process of becoming parents? Are you able to name common birth and postpartum dynamics that come up in lesbian partnerships, for transgender parents, and extended co-parent families?

You can educate yourself by reading books about LGBTQ family- building:

The New Essential Guide to Lesbian Conception, Pregnancy and Birth
And Baby Makes More
Confessions of the Other Mother

Attend an LGBTQ cultural sensitivity training that is specific to birth and family-building:

MAIA Midwifery LGBTQ Cultural Sensitivity Trainings

Check out websites and blogs about LGBTQ parenting:

http://www.mombian.com/
http://www.lesbiandad.net/
http://itsconceivablenow.com/
http://www.milkjunkies.net/

I do not recommend that non-LGBTQ allies teach this specialized class. Instead, enthusiastically refer LGBTQ families to a specialized class if there is one in your area, explaining the value that so many families have found in attending a childbirth class with other queer families. (Read about ways to make your mixed class supportive for LGBTQ families here and a lesbian couple’s CBE class experience  here.)  The sense of safety that is created when a marginalized group gathers exclusively allows something to happen that would not happen in a mixed group. Being in “safe space” provides a sense of common understanding that goes way beyond welcome and acceptance. It allows for dialogue regarding a common lived experience and a shared cultural identity. There is a sense of knowing – not needing to explain the things that to an outsider could be explained, but would not truly be understood without direct, lived experience. Kind of like becoming a parent.

If you are interested in teaching childbirth classes for LGBTQ families in your community, please don’t hesitate to contact me.

Are there educators in your community who teach LGBTQ childbirth classes?  Maybe you are one of those educators?  Do you see the need for such classes in your community?  Share your experiences and observations with our readers on specialized classes such as this. – SM

About Kristin Kali

© Kristin Kali

© Kristin Kali

Kristin Kali, LM CPM is the owner of MAIA Midwifery and Fertility Services, a fertility-focused midwifery practice that provides holistic, individualized care. MAIA serves all families, with specific expertise in serving LGBTQ families, single parents by choice, transgender parents and those conceiving over 40. Fertility consultations, classes and support groups are available in Seattle, Oakland, and online.

Kristin is a Certified Professional Midwife through the North American Registry of Midwives. She is a Licensed Midwife in California and Washington. Kristin is a graduate of Seattle Midwifery School and a member of the Midwives Association of North America, National Association of Certified Professional Midwives, American Society for Reproductive Medicine, Gay and Lesbian Medical Association, California Association of Midwives, and Midwives Association of Washington State.

Childbirth Education, Guest Posts, Parenting an Infant, Series: Welcoming All Families , , , ,