Science & Sensibility

By Geradine Simkins, CNM, MSN, Executive Director of Midwives Alliance of North America

This week, the American Academy of Pediatrics released a policy statement on home birth. While the statement affirmed “the right of women to make a medically informed decision about delivery”, many advocates expressed concerns. The statement failed to recognize Certified Professional Midwives, the providers most likely to attend a home birth in the United States. In this response, the Midwives Alliance of North America helps families, providers, and policy makers understand the critical role CPMs play in safe, healthy birth options. – Sharon Muza, Community Manager, Science & Sensibility

High-quality out-of-hospital newborn and postpartum care is standard for midwives

 

The Midwives Alliance of North America welcomes the primary concept communicated in the American Academy of Pediatrics’ April 24, 2013, policy statement entitled “Planned Home Birth.” As should be expected, AAP reminds its practitioners that newborn infants—regardless of the setting in which they are born—deserve an equal and unbiased, high-quality standard of care. The Midwives Alliance joins with AAP in affirming the need for a collaborative and integrated maternity care system that addresses the needs of all mothers and infants, regardless of the provider type or birth setting a woman chooses.

We are disappointed, however, in AAP’s decision to align with the American Congress of Obstetrics and Gynecologists’ policy on home birth. Serving the needs of the growing number of families choosing to birth at home, Certified Professional Midwives attend the majority of intended home births in the U.S., when a skilled attendant is present, making them the primary care providers for newborns in the home setting.

Certified Professional Midwives are skilled maternity care providers

AAP’s itemized recommendations for infant and newborn care, contained in their policy statement, are standard practice for credentialed midwives. In that respect, we find much with which we agree. These standard newborn exams, screens, and preventative care practices are wholly part of a credentialed midwife’s scope of practice, and further endorsed by individual state health departments. We also note that as AAP Neonatal Resuscitation Program certificate holders (required for certification and recertification), credentialed midwives follow guidelines laid out in AAP’s recommendations, and typically surpass those standard recommendations by having at least two NRP- and CPR-trained attendants at out-of-hospital births.

In fact, the AAP’s guidelines for the care of infants intentionally born at home parallel those standards practiced by trained midwives in all birth settings. The practices listed—such as working medical equipment, emergency plans of transfer, thorough newborn exams, and so forth—are professional standards exhibited and documented by credentialed midwives, regardless of the place of birth.

The AAP policy statement, however, did not recognize or acknowledge Certified Professional Midwives (CPM), indicating that AAP may not have a thorough understanding of the training, skills, knowledge, and abilities of this country’s primary maternity care provider for infants born out of the hospital. The Certified Professional Midwife is the only national midwifery credential that requires practitioners to be trained specifically to provide prenatal, intrapartum, and postnatal care in out-of-hospital settings. CPMs are knowledgeable, expert and independent midwifery practitioners who have met the standards for certification set by the North American Registry of Midwives (NARM). NARM is accredited by the National Commission for Certifying Agencies (NCCA) to issue the professional credential of Certified Professional Midwife, which is the same agency that accredits the American Midwifery Certification Board to issue the professional credentials of Certified-Nurse Midwife, and Certified Midwife.  

Midwives are the providers of choice for out-of-hospital births, whether they occur at home or in freestanding birth centers. Offered since 1994, the CPM is currently the basis for licensure in 27 states while 11 additional states are actively seeking CPM licensure. In fact, one in nine newly certified midwives in the U.S. are Certified Professional Midwives.  

The AAP policy statement endorses birth center maternity care, which is another area in which we are in agreement. Recent numbers from the American Association of Birth Centers (AABC) indicate that a significant proportion of accredited birth centers are owned and operated by Certified Professional Midwives. A January 2013 study, The National Birth Center Study II , conducted by AABC and published in the Journal of Midwifery & Women’s Health, the official journal of the American College of Nurse-Midwives (ACNM), highlights the benefits for women who seek care at midwife-led birth centers. Findings also reinforce longstanding evidence that providers at midwife-led birth centers provide safe and effective health care for women during pregnancy, labor, birth, and the postpartum period.  

Midwives provide high-quality care that meets both national and international guidelines 

In highlighting the ethic of high-quality care for all infants across the spectrum—regardless of the site of birth—it should be noted that Certified Professional Midwives provide care intentionally similar to that of nurse-midwives and physicians. Yet we also know that CPMs are able to offer additional and valued care in terms of frequency of home visits and intense monitoring of newborns in their homes in the first weeks of life—a benefit not normally conferred to women and babies who have experienced hospital births.

This high-quality midwifery care includes routine newborn APGAR assessments, comprehensive head-to-toe physical examinations, measurements of length, head, abdomen and birth weight, monitoring vital signs including thermoregulation, assessment of respiratory sounds and patterns, assessments of cardiac sounds and peripheral pulses, assessment of gestational age and physical maturity, neuromuscular assessments, and assistance with initiation and ongoing assessment of breastfeeding. All findings are recorded in patient records and shared with mothers, per professional standards.

In addition, CPMs provide newborns with Vitamin K treatment, antibiotic eye ointment, umbilical cord care, metabolic newborn screening, glucose and bilirubin testing as indicated, and either perform Otoacoustic Emissions (OAE) hearing screens or refer to area audiologists. Midwives in a number of states are moving toward, or already offering, pulse-oximetry screening for Critical Congenital Heart Defects (CCHD) per AAP guidelines, in advance of many hospital systems. In the rare cases when newborns require consultation or referral, infants are transferred to the tertiary care system, and pediatricians where available, for active management.

Not only do Certified Professional Midwives and Certified Nurse-Midwives who attend home births provide the level of care outlined by the AAP, they provide it in a personalized, woman-centered, family-centered, culturally competent, and individualized manner that is qualitatively different from the customary assembly-line postpartum care commonly experienced in U.S. hospitals.

For example, in a home birth setting, the midwife typically conducts the initial newborn exam in the presence of the mother and family, which does not disrupt the crucial process of mother-infant bonding and breastfeeding, and is focused on being instructive to the family. Midwives provide holistic care to the mother-baby dyad in concordance with World Health Organization’s Baby-Friendly best practices.

As a way of illustrating important differences in care practices, we can point to the recent Breastfeeding Report Card issued by the CDC (2012) that indicates only six percent of U.S. hospitals are offering care that aligns with the international best practices outlined by Healthy People 2020.   By contrast in a 2005 study, 95% of babies born at home under the care of Certified Professional Midwives were exclusively breastfeeding at six weeks of age (Johnson & Daviss, 2005). This is just one area where midwives are well-trained, skilled, and uniquely positioned to help families succeed.

An opportunity for collaboration and integrated care 

Physician conversations about home birth and midwife-led birth will be better informed and more useful to maternity care consumers if AAP is able to become more cognizant of important changes in the landscape of U.S. midwifery. 

The release of the AAP policy statement on care of newborns born at home is an opportunity to reinforce the need for professional and seamless collaboration with members of community health care teams. We view this statement’s release as an opportunity to align best practices for all parties who care for and support families choosing home birth.

The Midwives Alliance stands ready to work with other pediatric and maternity care providers to establish best practices in the postpartum period to not merely provide the basic level of care in the first hours, days and weeks of life for the newborn as outlined in the latest AAP statement, but to elevate that standard to include support for breastfeeding and the personal attention that can prevent infant death and improve maternal and child health.  Babies born in all settings deserve this kind of care.

About Geradine Simkins

Geradine Simkins, CNM, MSN is an activist, midwife and author. She began as a direct-entry home birth midwife in 1976 and became a nurse-midwife twenty years later. For over thirty years she has provided health care for women, infants and families in a variety of settings, including attendance at births in the home, a freestanding birth center, and hospitals. Geradine’s work with migrant farmworkers and American Indian tribes focuses on addressing health care disparities and engendering a more equitable maternity care system for all women and infants.  Geradine is currently the Executive Director of Midwives Alliance of North America, a professional organization that promotes excellence in midwifery and is dedicated to unifying and strengthening the profession, thereby increasing access to quality health care and improving outcomes for women, babies and their families. She is the editor of the recently published book entitled Into These Hands: Wisdom from Midwives, an anthology of the life stories of 25 remarkable women who have dedicated their lives and careers to the path of midwifery and social change.  More info about Geraldine Simkins can be found here.

Sharon Muza ACOG, American Academy of Pediatrics, Babies, Delayed Cord Clamping, Home Birth, informed Consent, Maternity Care, Midwifery, Transforming Maternity Care AAP, ACNM, ACOG, CNM, CPM, Geraldine Simkins, Home Birth, MANA, Midwifery Care, Midwives Alliance of North America, newborn

In the occasional series on Welcoming All Families, we have explored how to make our classes and practices welcoming for women of size and lesbians.  Today on Science & Sensibility, Certified Nurse Midwife Simon Adriane Ellis shares how to offer care and classes that are sensitive to gender variant families. Recently the American College of Nurse-Midwives (ACNM) released a position statement on Transgender/Transexual/Gender Variant Health Care. The ACNM stated that they “support efforts to provide transgender, transsexual, and gender variant individuals with access to safe, comprehensive, culturally competent health care and therefore endorses the 2011 World Professional Association for Transgender Health (WPATH) Standards of Care.”  Simon Ellis served on the task force and played a significant role in writing and advocating for this recently released position paper and worked with ACNM to see it through Board of Director approval in December 2012. – Sharon Muza, Science & Sensibility Community Manager

_______________________ 

Note: The term “gender variant” is used throughout this post to describe individuals whose gender identity is in some way different than the sex they were assigned at birth. Other related words you may have heard before include transgender, gender non-conforming, and gender non-binary. In this post, I specifically address the needs of gender variant people who undertake pregnancy. The needs of gender variant partners and family members also warrant deep consideration, but will not be the focus of this piece. 

When asked, many birth professionals will tell you that they’ve never cared for a gender variant patient. Many of us claim that we don’t have the skills or the knowledge to do so. Turns out we’re usually wrong, on two fronts. First, chances are many of us have served gender variant people, without knowing it. And second, we are competent, compassionate, and well-trained professionals who already have what we need to provide excellent care and services to our gender variant patients. This post will provide a basic framework for approaching care, as well as some specific resources and suggestions to make your practice more inviting. I write it from both my perspective as a practicing Certified Nurse Midwife, and my perspective as a gender variant person (female-to-male).

Focus on What You Bring to the Table

We all bring ourselves – rich in beauty and flaws and experience – to each client encounter. We are our own building blocks of clinical or professional practice. Accordingly, when striving to provide care or services across difference, the first place to start is within ourselves. What do we bring? Among other things, we bring skills and biases.

Skills

As professionals who serve families in pregnancy and birth, the core of what we provide is compassion; we are incredibly dexterous at meeting people where they are at. We offer a strong and loving presence even in the intense terrain of labor, which takes a whole lot of humanity and skill. This is your number one asset for providing culturally responsive care to gender variant patients and clients. So keep doing what you do best! 

Biases

If someone asks you why you choose to do birth work, what do you say? Many of us would say that we are passionate about serving women, that we value women’s bodies and autonomy and we honor the journey to motherhood. Which is fantastic! We should! But what if your pregnant client doesn’t happen to identify as a woman? Does that change anything about the importance of their journey to parenthood? Does it make their birth experience less authentic and worthy of support? Of course not. Birth is birth, regardless of gender identity. And birth is our specialty. But many of us have a very hard time imagining pregnancy outside the concept of “woman,” which casts doubt on gender variant people who choose to carry a pregnancy. Being aware of and challenging your own biases and personal attachments to the concept of gender will help you prepare yourself for working with a more diverse client base. 

Don’t Pass the Buck

It is convenient to fall back on the idea that we, as birth professionals, are only trained to work with women and therefore are simply not qualified to work with gender variant people. In saying this, we falsely join two separate concepts – sex and gender – and we falsely absolve ourselves from responsibility. The urge to refer clients/patients to “someone who has more experience” is strong; often, it is grounded in sincere concern for the client’s wellbeing. But the truth is: with very few exceptions, there is no one with more experience.

In my work with gender variant parents, every single one of their doulas, childbirth educators, midwives, and OBs stated they had never before worked with a gender variant patient. There was no research these providers could review on the physical and emotional health needs of this population, no information on best practices. Each provider had to rely on the skills and knowledge base they already had, and do the best they could. And with compassion and clinical/professional acumen as their guide, it turns out they usually did an awesome job. The lesson to take from this is that 1) you are capable of doing a good job, and 2) a suggestion that the patient see “someone who has more experience” is usually little more than a referral to nowhere. 

Make Your Practice More Inviting

While there is no simple list of do’s and don’ts that you can follow (and the golden rule is, as always, to cater your approach to the needs of the specific client), I do think there are some basic principles that can be helpful in adapting your practice to meet the needs of gender variant patients and clients.

1. Build trust and offer accommodations

Fear of discrimination by providers and fellow patients or class participants presents a huge barrier to care for gender variant people. It is a source of great emotional and physiological stress. I can tell you that it is truly a terrible feeling. Take time to build trust, and to assess your client’s need for accommodations. Some clients will desire as much anonymity as possible, in which case you can offer one-on-one class sessions or facility tours, appointments at the beginning or end of the clinic day, assurances of privacy, and continuity of care. Other clients will desire facilitated integration, in which case you can offer assurance that you will address problems proactively, be available to address questions raised by other clients, and make a point to check in regularly on how things are going. If you need to refer the client to another provider, be sure to offer to call ahead and provide the patient’s background. Taking over the burden of explanation can be an enormous weight off your client’s shoulders.

2. Plan to offer additional emotional support

We all know that pregnancy is an intense and vulnerable time. Gender variant parents-to-be often have the additional struggle of profound isolation, coupled with the likelihood of heightened gender dysphoria during the course of pregnancy. With these things in mind, make yourself available to provide additional emotional support as necessary. Research LGBTQ friendly mental health providers in your area so you are able to make appropriate referrals if needed.

3. Keep your wording flexible

The language of birth work is extremely gendered. This can be isolating for gender variant clients. Work to make your language more inclusive by incorporating terms such as “pregnant parents,” “parents-to-be,” “new parents,” and “gestational parents.” Ask your clients what name, pronoun, and parenting term they would like to be addressed by, then respect their wishes in both individual and group settings. If you slip up and use the wrong name or pronoun, acknowledge it promptly and succinctly, then move on. If you work with a staff, make sure that all staff members are addressing the patient or client appropriately as well. Including fields asking for “preferred name” and “pronoun” on your intake or registration forms will send a clear (and very relieving!) signal to potential clients.

4. Don’t let curiosity get the best of you

I can tell you from personal experience that gender variant people are constantly asked about our gender identities. Regardless of the context or topic of discussion, we are expected to be willing and able to explain our innermost sense of self (or defend our right to exist!) at all times. This is stressful! While your curiosity may stem from a desire to better understand your client’s gender experience, and you should be open to hearing about their experience, focus on the pertinent issues at hand. Maintain your professional integrity and ask only what you need to know in order to provide excellent care.

5. Address issues proactively, especially in group settings

If you see clients in a group setting, consider a handout or brief talk at the beginning of each class (regardless of who is in attendance) affirming that there are many different types of families and that intolerance will not be allowed. Name behavior firmly but gracefully when someone acts inappropriately, and follow up with them individually outside of the class setting. Do not place the burden on your gender variant clients to defend themselves – instead, show them that you are a dependable professional who has their back and is willing to help other clients grow and become more accepting.

Thank you so much for your commitment to serving gender varient people!

Creating a class or practice that is welcoming to all families can involve sharing stories of all different families.  Choosing your media, handouts, posters and class material that includes all the different ways that families can look is important.  Please share your favorite resources for these types of supplies.  There is not a lot to choose from and we can all benefit from sharing information.  What do you do (or what have you done) to welcome gender variant families into your classes and practices?  Please share your experiences in the comments section.- Sharon Muza

Resources

Resources on this issue are few and far between, unfortunately, but here are some good places to start:

Basic vocabulary and introduction to the issue of gender variance: http://srlp.org/trans-101

2010 healthcare discriminatory survey: http://www.thetaskforce.org/downloads/resources_and_tools/ntds_report_on_health.pdf

Blog by a transgender dad who breastfeeds his son – lots of good information as well as personal reflections: http://www.milkjunkies.net/

Resources for gender variant parents – includes legal resources and family support resources: http://www.transparentcy.org/Resources.htm

Gender and the Childbirth Professional Facebook group – connect with other providers who work with gender variant clients, ask questions, post resources, etc.: https://www.facebook.com/groups/265359336861854/?fref=ts

My personal blog – occasional updates on midwifery, sexual health, and what’s it’s like to be a gender variant midwife: www.boimidwife.wordpress.com

It’s My Body, My Baby. My Birth – DVD for use in class that shows 7 natural births and interviews the couples.  One couple is gender variant.  http://www.itsmybodymybabymybirth.com/Home.html

Additionally, the ACNM Position Statement contains additional resources on this topic.

Thank you so much for your commitment to serving gender varient people!

 About Simon Adriane Ellis

Simon Adriane Ellis is a Certified Nurse Midwife, trained doula, and queer and gender variant person. He has a long history of social justice organizing around issues of racial and economic justice and LGBTQ rights, and brings these values to his work as a midwife. His practice is focused on providing empowering sexual and reproductive health services across the lifespan for people of all gender identities. He is currently working to publish his original qualitative research on the conception, pregnancy, and birth experiences of gender variant gestational parents. He hopes that this work will provide a broad call to challenge conventional assumptions about what pregnancy looks and feels like for all of our clients, regardless of gender identity. Simon can be reached through his midwifery practice, Essential Healthcare + Midwifery Services.

Sharon Muza Childbirth Education, Guest Posts, Legal Issues, Midwifery, Series: Welcoming All Families ACNM, ACNM Position Statement, American College of Nurse-Midwives, Childbirth Education, Gender Variant, Midwifery Care, midwives, Sharon Muza, Simon Adriane Ellis, Transgendered, welcoming all families

In May of this year, three leading midwifery organizations, American College of Nurse Midwives (ACNM), Midwives Alliance of North America (MANA) and National Association of Certified Professional Midwives (NACPM) jointly released a statement titled “Supporting Healthy and Normal Physiologic Childbirth; A Consensus Statement by ACNM, MANA and NACPM,“ intended for health care professionals and policymakers.  This strongly worded statement supports healthy and normal physiologic childbirth for for U.S. women. It is logical that the three main U.S. midwifery organizations coordinated in preparing this statement, as midwives are the gatekeepers of normal birth for low risk women.   The purpose of the consensus statement, which was developed by a joint task force appointed from members of the three midwifery organizations was to:

• Provide a succinct definition of normal physiologic birth;
• Identify measurable benchmarks to describe optimal processes and outcomes reflective of normal physiologic birth;
• Identify factors that facilitate or disrupt normal physiologic birth based on the best available evidence;
• Create a template for system changes through clinical practice, education, research, and health policy; and
• Ultimately improve the health of mothers and infants, while avoiding unnecessary and costly interventions.

A normal physiologic labor and birth is one that is powered by the innate human capacity of the woman and fetus. This birth is more likely to be safe and healthy because there is no unnecessary intervention that disrupts normal physiologic processes.  Some women and/or fetuses will develop complications that warrante medical attention to assure safe and healthy outcomes.  However, supporting the normal physiologic processes of labor and birth, even in the presence of such complications, has the potential to enhance best outcomes for mother and infant.

These three organizations recognize the current state of U.S. maternity care and acknowledge how technology and interventions are being commonly used despite the lack of scientific evidence supporting routine applications. (Sakala, 2008.)  Some of the interventions cited including pitocin being used to induce or augment more than half of all pregnant women’s labors. (Declercq, Sakala, 2006.)  The cesarean rate in the United States is more than 33%. (Martin,Hamilton, Ventura 2011.) This cesarean rate is not without risks for both mothers and babies with the original cesarean birth but also recognizes the complications to subsequent pregnancies and birth.  The organizations also commented that women who have perceived their birth or the care they received as traumatic or disrespectful are more likely to develop postpartum mood disorders and potentially difficulty in establishing healthy mother-infant attachment. (Beck, 2004), (Beck, Watson, 2008), (Beck, 2006).

The consensus statement goes on to state the characteristics of normal physiologic birth;

• is characterized by spontaneous onset and progression of labor;
• includes biological and psychological conditions that promote effective labor;
• results in the vaginal birth of of the infant and placenta;
• results in physiological blood loss,
• facilitates optimal newborn transition through skin-to-skin contact and keeping the mother and infant together during the postpartum period; and
• supports early initiation of breastfeeding. (World Health Organization 1996).

When I was reading the above list, as outlined by the World Health Organization and cited in the consensus statement,  I was stuck by how these statements are in sync with Lamaze International’s Healthy Birth Practices.  I was also a bit discouraged that these statements, published by WHO in 1996 sometimes still seem a distant goal.

There are factors that interfere with the normal physiologic process, including many that you may be very familiar with; induction or augmentation of labor, lack of a supportive environment, time limits on labor, denial of food and drink, pain medications, episiotomies, vacuum or forceps assisted deliveries, cesareans, immediate cord clamping, separation of the new mother from her newborn and finally, a situation that may feel threatening or unsupportive to the mother.

The consensus statement recognizes the numerous short-term and long-term health implications of normal birth to the mother-baby dyad.  Allowing labor and birth to unfold without interference permits labor and birth hormones to work effectively, thereby reducing the need for the familiar “cascade of interventions.”

For most women, the short-term benefits of normal physiologic birth include emerging from childbirth feeling physically and emotionally healthy and powerful as mothers…A focus on these aspects of normal physiologic birth will help to change the current discourse on childbirth as an illness state where authority resides external to the woman to one of wellness in which women and clinicians share decisions and accountability. (Kennedy, Nardini, McLeod-Waldo, 2009).

When women enter motherhood from a position of strength and confidence, babies benefit, families benefit and society benefits.  Multiple factors for the woman, the clinician and the birthing environment help to promote women birthing without intervention.  All three sides of an important triad need to share equal responsibility in meeting this goal.

The consensus statement indicates that education plays a role in helping women obtain a normal physiologic birth.  The role of the childbirth educator cannot be underestimated.  Sharing the values of Lamaze and the Lamaze Healthy Birth Practices is right in line with the midwifery statement.

ACNM, MANA and NACPM go on to encourage hospital policies to be set that support normal birth, the recognition that care practices need to be evidenced based.  Midwifery care is a “key strategy” in that direction.  Education of clinicians on care practices that promote physiologic birth and furthering research on the effects of normal birth, among other things.

This consensus statement is clear and powerful in demonstrating that our mothers and babies deserve, depend on and require the opportunity to birth without interventions and that everyone will benefit as a result, in the absence of medical complications or medical need.  I look forward to policy changes, increased accessibility of mothers to midwives and the midwifery model of care and collaboration of all health care providers, both doctors and midwives, to promote practices that result in an increase in normal physiologic birth.

Take a moment to read the entire consensus statement and let me know what you think?  A step in the right direction?  What comes next?  Do you think it is exciting that these three organizations have worked together to come out with this bold challenge to make change? What do you do in your childbirth classes or with the women you work with to promote these values represented by the consensus statement.  Would you add anything else?   I welcome your discussion in our comments section. – SM

 Sources

Beck CT. Birth trauma: in the eye of the beholder. Nurs Res. 2004; 53(1):28-35.

Beck CT, Watson S. The impact of birth trauma on breastfeeding: a tale of two pathways. Nurs Res. 2008; 57(4):228-236.

Beck CT. The anniversary of birth trauma: failure to rescue. Nurs Res. 2006; 55(6): 381-390.

Beck CT.Post-traumatic stress disorder due to childbirth:the aftermath.NursRes, 2004; 53(4):216-224.

Declercq ER, Sakala C, Corry MP, et al. Listening to mothers II: Report of the Second National U.S. Survey of Women’s Childbearing Experiences. New York: Childbirth Connection; 2006.

Kennedy HP, Nardini K, McLeod-Waldo R, et al. Top-selling childbirth advice books: a discourse analysis. Birth. 2009;36(4):318-324.

Martin JA, Hamilton BE, Ventura SJ, et al. Births: preliminary data for 2010. Natl Vital Stat Rep. 2011; 60(2):1-25.

Sakala C, Corry MP. Evidence-based maternity care: what it is and what it can achieve. New York, NY: Milbank Memorial Fund; 2008.

World Health Organization. Care in Normal Birth: A Practical Guide. World Health Organization; 1996.

Sharon Muza Babies, Breastfeeding, Cesarean Birth, Childbirth Education, Epidural Analgesia, Evidence Based Medicine, Healthy Birth Practices, Healthy Care Practices, Home Birth, Infant Attachment, informed Consent, Maternal Mental Health, Maternal Mortality, Maternal Quality Improvement, Medical Interventions, Midwifery, Newborns, Pain Management, Push for Your Baby, Transforming Maternity Care ACNM, birth trauma, Healthy Birth Practices, Healthy Care Practices, infants, interventions, Lamaze International, MANA, Midwifery Care, midwives, NACPM, newborns, Sharon Muza, traumatic birth, WHO, World Health Organization

UPDATE:  The homebirth summit is underway, as we speak.  With numerous stake holders at the table together in Warrenton, VA , including OBs & FPs, midwives, nurses, insurers, childbirth educators, administrators, doulas, public health professionals, legislatures, and researchers…there is certainly hard work afoot as the hand-selected meeting attendees work to hammer out consensus on the role homebirth does (and should) play in our country, how best to implement inter-discipline collaboration, as well as ensuring situations like seamless (and respectful) transfers from home to hospital when the need arises.  With several Lamaze International members attending the conference, I hope to bring you some commentary on the summit in the weeks to come. -KMH]

 

This coming October, midwives, doctors, childbirth educators, hospital administrators, health policy regulators, and public health professionals will get together with key representatives from organizations such as ACNM, MANA, ACOG, AAP,  NACPM, ICTC, Lamaze, AABC,  Our Bodies Ourselves, and AWHONN.  This collective group–all stakeholders in the planned home birth debate–will descend upon a yet-to-be-decided venue to discuss the various sides of the issue, and seek common ground that will, ultimately, benefit mothers opting for planned home birth and their babies.

Says Judith Lothian, RN, PhD, LCCE, FACCE, Associate Professor of Nursing at Seton Hall University, Associate Editor of the Journal of Perinatal Education, and Lamaze International’s representative to the planned home birth consensus committee:

 

The planning for the home birth consensus meeting began several years ago. I was fortunate to be part of “making history” at the first planning meeting in San Francisco in 2009. For the first time, obstetricians, pediatricians, midwives (including certified professional midwives), childbirth educators, maternity nurses, and birth advocates guided by the courageous vision and commitment of Saras Vedam, sat at the same table and talked (and listened). It was amazing. We left that meeting excited and hopeful. In the last few months, with some funding, the planning for the consensus meeting is finally moving forward. The consensus meeting planned for October 2011 will be the first time that all those with a stake in the planned home birth issue will talk, listen, reflect and, hopefully, find areas of agreement that will ultimately make a difference for mothers and babies. It is so important that Lamaze, representing childbearing women, childbirth educators, and birth advocates, is at the table. This will be a historic and hopefully “birth altering” event.

 

 

To find out more about the Home Birth Summit, go here.

 

Posted by:  Kimmelin Hull, PA, LCCE

Kimmelin Hull Conference Schedule, Home Birth, Uncategorized ACNM, ACOG and homebirth, homebirth consensus committee, homebirth debate, Judith Lothian, Lamaze International, Our Bodies Ourselves, planned home birth summit 2011

With the New Year well under way, it’s a good time to cast a giant spotlight on the conference schedule for the year…and boy, is there a lot to choose from!  Below you will find conferences listed according to discipline and (mostly) by date.  I commend each and every reader to attend at least one conference from the following list.  There is SO MUCH happening in terms of research and development of evidence-based care practices in the realms of perinatal, lactation and maternal mental health care…keeping up to date on-line is wonderful, but being a part of the action in person, as it is unfolding, is another experience entirely!

~ Childbirth Education ~
Lamaze’s Annual Conference:  “Steering Change for Safe and Healthy Birth” in Fort Worth, TX Sept 15-18

Regional Association of Childbirth Educators of Puget Sound (REACHE) in Tacoma, WA March 4 featuring guests speakers Michele Deck, Pamela England and Sheri Deveney.

Health Connect One’s Fifth Annual Conference:  “Birth, Breastfeeding and Beyond: Sustaining Community-Based Practices” Washington DC March 21-23 which will further the organization’s efforts to sustain community-based maternal and child health practices in underserved communities.

International Childbirth Education Association (ICEA) Regional Conferences in Washington DC (March 26), Pensacola, FL (May 4-6), Sacramento, CA (May 13-15), Minneapolis, MS (June 23-24), Knoxville, TN (Sept 28-Oct 1), Burbank, CA (Oct 22-24), Anchorage, AK (Oct).  **Featured speakers at individual regional conferences include Penny Simkin, Henci Goer, Marilyn Hildreth, Jeanette Swartz, Ina May Gaskin, Kathleen Kendall-Tackett and others…

Childbirth and Postpartum Professionals Association (CAPPA) Annual Conference in Valencia, CA June 23-26 (with pre- and post-conference special workshops  June 21-23; 27-28)

~ Midwifery ~
Midwifery Today’s Conference: “Gentle Birth is a Human Rights Issue” featuring a keynote address by Dr. Michele Odent in Eugene, OR March 3 – April 3

Midwives Alliance of North America (MANA) Regional Conferences in the Chesapeake Bay area, MD (May 1) and Cary, NC (Aug 6-7). Their joint conference with the Canadian Association of Midwives will be in Niagara Falls, Ontario Nov 9-11.

American College of Nurse Midwives (ACNM) 56^th Annual Meeting in San Antonio, TX  May 24-28

International Center for Traditional Childbearing’s Midwifery Conference in Biloxi, MS Oct 15-17

*For additional midwifery-related conferences, go here: http://www.midwife.org/master_calendar.cfm

~ Doulas ~
Childbirth and Postpartum Professionals Associations (CAPPA) Annual Conference in Valencia, CA June 23-26 (with pre- and post-conference special workshops June 21-23; 27-28)

Doulas of North America (DONA) 17^th Annual Conference in Boston, MA July 21-24

~ Perinatal Mental Health ~
Postpartum Support International (PSI) 25^th Annual Conference: “Whole Care for the Whole Family” in Seattle, WA Sept 16-17 (with pre-conference workshops and activities Sept 14-15)

~ Improving Maternity Care Research & Advocacy Groups ~
Coalition for Improving Maternity Services:  “Reframing Birth and Breastfeeding:  Moving Forwrad” in Chapel Hill, NC March 11-12 with pre-conference workshops Mar 10.

International Cesarean Awareness Network’s Annual Conference;  “Your Gateway to a Better Birth” in St Louis, MO April 8-10

Partners in Perinatal Health 22^nd Annual Conference in Norwood, MA May 17

Perinatal Advisory Council:  Leadership, Advocacy & Consultation’s 15^th Annual Conference: “Quality of Life for Families XIV: Improving the Outcomes of Pregnancy” in Los Angeles, CA May 25-26

~ Nursing ~
March of Dimes’ 36^th Annual Perinatal Nursing Conference in Oak Lawn, IL  March 3-4.
Various topic tracks will be featured at this conference, including: Public Health, High Risk Newborn, Lactation, L&D/Mother Baby.

Association of Women’s Health Obstetric and Neonatal Nurses’ (AWHONN) Annual Convention in Denver, CO June 25-29.

~ Medical Conferences ~
American College of Gynecologists (ACOG) – 59^th Annual Clinical Meeting in Washington DC April 30 – May 4.

For American Academy of Family Physicians conferences related to maternity care and women’s health issues, go here for future listings: http://www.aafp.org/online/en/home/cme/aafpcourses/conferences/aafpevents/byevent.html#Parsys64996

~ Public Health ~
Association of Maternal & Child Health Programs’ (AMCHP) Annual Conference in Washington DC Feb. 12-15

Healthy Mothers, Healthy Birth Summit will take place in northern Virginia on April 9. The summit will call together physicians, researchers, midwives, childbirth professionals, and advocacy groups to examine the rising maternal mortality rate in the US.

~ Lactation Support ~
International Lactation Consultant Association (ILCA): “Raising the Bar: Enhancing Practices and Improving Health Outcomes” in San Diego, CA July 13-17

Nursing Mothers’ Council Breastfeeding Conference in Boxborough, MA on April 1

To see an entire years’ worth of breastfeeding support-related conferences, go here:  http://www.breastfeedingconferences.com/ (U.S. and international conferences listed)

~ Others ~
Rehabilitation Institute of Chicago’s “Evidence Based Solutions for Improving Pelvic Floor Health and Function – Women’s Health Rehabilitation Symposium & Post-conference Workshop” in Chicago, IL May 13-14

~ International ~
The Lancet journal launches a new series on the issue of stillbirth with simultaneous press conference events in Johannesburg, South Africa and London, England on March 8.  For more information, visit the Lancet’s website (following the launch) and International Stillbirth Alliance’s website.

Association of Radical Midwives National Meeting in Wigan, UK March 19.

3^rd International Nursing and Midwifery Conference (hosted by hosted by the School of Nursing & Midwifery, National University of Ireland) in Galway April 4-5

International Confederation of Midwives 29^th Triennial Conference in Durban, South Africa June 19-23.

New Zealand Lactation Consultants Association (NZLCA) Conference:  Breastfeeding:  Passport to Life in Christchurch, NZ Aug 26-28.

Australian College of Midwives 17^th Annual Conference:  “A Midwifery Odyssey” in Eveleigh, Sydney Oct 18-21.

If you are aware of a conference worthy of being on this list, please add the relevant information via the Comments box below…

Kimmelin Hull Conference Schedule, Evidence Based Medicine, Research for Advocacy AAFP annual conferences, ACNM, ACOG, AWHONN, breastfeeding support continuing education, CAPPA, chidbirth education conferences, childbirth conferences, Coalition for Improving Maternity Care, DONA, doula conferences, Henci Goer speaking schedule, ICAN, ICEA, Ina May Gaskin speaking schedule, lactation consultant conferences, Lamaze International, MANA conference, March of Dimes, maternity care conferences, maternity care continuing education, Michel Odent speaking schedule, midwifery conferences, Midwifery Today's conference, Penny Simkin speaking schedule, perinatal nursing conferences