24h-payday

Archive

Posts Tagged ‘Childbirth Education’

Lessons from a Snow Field

January 23rd, 2014 by avatar

Today’s post is written by Kimmelin Hull, former community manager for Science & Sensibility.  Kimmelin shares how the lessons parents receive in their Lamaze classes prepare them well for many of life’s experiences that may lay ahead.   I can think of many things that I teach in a standard Lamaze class that can become life skills that will serve families well long after the little one has grown. – Sharon Muza, Community Manager, Science & Sensibility

source: flic

source: flic

On January 17, 2014 a group of friends were out snowmobiling in Cooke City, South Central, Montana.  At a critical moment during the sledding trip, one group member steered his snow mobile up a slope while his friends were further below.  Loosening the snow pack that overlay a weak under layer, he set off an avalanche that quickly buried one of the group members on under four feet of snow.

What does this have to do with Lamaze and childbirth?  Just wait.

Within moments of the avalanche burying his friend, one of the group members assisted in locating and extracting the buried snowmobiler with the use of an emergency beacon and a shovel.  Buried for ten minutes, the avalanche victim displayed neither respirations nor a pulse.  For all intents and purposes, he was clinically dead. Recalling CPR skills he’d learned while taking a Lamaze class with his wife, the rescuer performed cardiopulmonary resuscitation on his friend, successfully reviving him.  Many are calling this a miracle, as the combination of circumstances made it highly unlikely the man buried under snow would survive. Here is the full story.

As childbirth educators, we have the capacity to impact the lives of our clients in so many ways.  Going above and beyond teaching the stages of labor and pain coping techniques, we teach our clients self-empowerment, navigation of complex health care environments and, yes, some of us even teach life-saving skills.

While operating my childbirth preparation program in Bozeman, Montana for over 6 years, I included infant/child CPR in my class curriculum.  Having been trained previously as a first aid/CPR instructor through the American Red Cross, I had both the capacity and the motivation to incorporate these life-saving skills into my curriculum.  I can’t tell you how many of my clients thanked me specifically for that portion of the program; they felt prepared, “just in case anything were to happen” in terms of a life-threatening breathing or cardiac emergency with their soon-to-be-born baby.

source: flickr

source: flickr

An alternative to becoming trained in first aid/CPR instruction is to contract with a local instructor, inviting them to attend a single class during which they can share the easy-to-learn skill of performing CPR (the American Red Cross has simplified the training in recent years).

There are so many ways in which we can enhance our childbirth education programs.  Some instructors incorporate extensive relaxation and meditation techniques in class.  Others extend their programs to offer considerable early parenting skills training.  Others still, spend valuable time discussing perinatal mood disorders, including identifying signs and symptoms, and local treatment resources.  The Lamaze Certified Childbirth Educators training program provides the canvas for our individual teaching endeavors; we create the masterpiece that becomes our approach to evidence-based, high quality education.  These adjuncts to the “traditional” childbirth preparation class represent skills and knowledge that a person can take with him or her, and benefit from, for life.

What have you done to enhance your program?  What specific needs do the clients in your communities have? Have you enriched your Lamaze classes with add-on curriculum that has been well received by your community?  Please share your ideas in our comments section so we can all learn from your experiences.- SM

About Kimmelin Hull

Kimmelin_Hull_ProfileKimmelin Hull, the previous Community Manager for Science and Sensibility, is completing her Masters of Public Health in Maternal and Child Health degree through the University of Minnesota.  She lives in Bozeman, MT with her husband and three children, and is an active member in numerous community health coalitions all of which promote health and well-being of women and their families.

Childbirth Education, Guest Posts, Lamaze International, Uncategorized , , ,

January is National Birth Defects Prevention Month – Are Your Resources & Information Up to Date?

January 21st, 2014 by avatar
image: NDBPN.org

image: NDBPN.org

January is National Birth Defects Prevention Month, and this year the campaign being presented is that birth defects are “Costly, Common and Critical.”  This campaign is sponsored by the non-profit organization National Birth Defects Prevention Network (NBDPN). The NBDPN is a volunteer-based collaborative non-profit that works to capture national statistics on the numbers and types of birth defects occurring in the USA, along with coordinating research and prevention efforts.  This multi-disciplinary organization is made up of public health officials, consumers and researchers working together to reduce birth defects and their short and long term consequences. They collaborate with the Center for Disease Control and Prevention and March of Dimes as well as other well known organizations and agencies.

image: NBDPN.org

image: NBDPN.org

One in 33 babies born are affected by a birth defect.  A baby with a birth defect is born every 4 1/2 minutes in the USA and these defects are responsible for one in five infant deaths. Not all birth defects are detected prior to birth, though many are identified during an ultrasound or amniocentesis.  There are some birth defects that are not detected before the newborn leaves the hospital. All birth defects are not related to genetics, some occur randomly during fetal development and others are a result of circumstances during pregnancy. Total hospital costs of children with birth defects exceed $2.6 billion. Congenital cardiac and circulatory birth defects account for $1.4 billion of these annual hospital costs.  Defects of the heart and limbs are the most common kind of birth defects. Only reasons for 30% of birth defects are known, but ongoing research is working towards identifying the unknown causes.

If you are an educator or a provider who offers a preconception class, your class is a great opportunity to share some of the resources on birth defect prevention, so that women and their partners can do what they can to reduce the likelihood of having a child with a birth defect.  That includes a discussion about getting enough folic acid, having regular medical checkups,  making sure medical conditions, such as diabetes, are under control, testing for infectious diseases and being up to date on vaccinations. Also avoiding cigarettes, alcohol and other drugs.

image: NBDPN.org

image: NBDPN.org

The NBDPN provides information and fact sheets on a variety of topics for consumers in both English and Spanish, as well as webinars that appeal to professionals, health care providers and researchers. They are also holding a virtual conference beginning in late February, that you can attend.

If you are not a health care provider, you may not know that a family in your class is carrying a baby with a birth defect.  They may disclose this information to the class, they may share with you privately or they may say nothing.  They might not even know themselves at the time.  It is imperative that you have resources available should they ask.  You may find out after the baby is born if class members stays in touch with you or there is a class reunion.  Your families may look to you for information and support.

Resources for your students and their families

Families you work with may also appreciate referrals to counselors, therapists and local support groups, to help them deal with the emotions and stress of having a baby with a birth defect, who may spend time in the NICU and be facing significant medical care, treatment and surgeries in the future.  Having a comprehensive list prepared in advance, with the appropriate local resources, will be helpful should you have a this situation.

As childbirth educators and other professionals working with an expectant family, we have an obligation to help prepare families for when things do not always go as planned.  The relationships we develop with families during the vulnerable year of pregnancy, birth and postpartum makes our role very important in helping families be ready for whatever comes.

Have you had a family in your class who delivered a baby with birth defects? Did they let you know about the circumstances?  Before or after birth? What did you do to help this family be prepared?  What resources did they find valuable?How did this affect what you said or did in your childbirth education course? Please sensitively share your experiences with our readers in the comments section so we can all be better prepared for supporting families whose child had a birth defect and their journey did not go as planned.

Babies, Childbirth Education, Newborns, Research , , , , , , , ,

A Tale of Two Cities from a Childbirth Educator’s Perspective

January 16th, 2014 by avatar

Today on Science & Sensibility, Laurie Levy, LMP, MA, CD(DONA, PALS), CBE, shares her experiences as a childbirth educator and doula recently relocated to a new state.  Her exposures to a new birth culture and method of doing things has taken her breath away, as she settles in to supporting families in her new home.  Learn more about Laurie’s experiences below.  Have you moved around the country and been surprised at the differences in practice you found?  Why do you think there is this difference?  Please discuss with us in the comments section. – Sharon Muza, Community Manager, Science & Sensibilityimage: http://screnews.com/greer/

hospital-signI moved from Seattle to Northern California this past September.  In Seattle, I was privileged to train and teach with leaders in the birth community for many years. Couple this with the 1998 passage of the WA Every Category of Health Care Provider Statute which compelled insurance agencies in WA state to cover licensed midwives and you can see why I would use the word ‘spoiled’ to describe my experience with birth in Seattle.

At a meeting with some of my new colleagues, I joked that I sound like I am saying, “And one time, at band camp…” when I talk about typical Seattle birth practices.  In the seven hospitals in the metro Seattle area, it was common to see moms moving about the halls with telemetry units.  Occasionally you would even see a woman out of bed and moving with an epidural in place. Vaginal exams were limited after the amniotic sac had ruptured. Babies were not routinely separated from their mothers.  The NICU came to the birth room if needed in most cases.  Mothers were encouraged to hand express colostrum to help a baby with unstable blood sugar. Babies were born directly on to their mother’s chest in some cesarean births. Hospitals competed for patient’s maternity care dollar offering ever improving birth suites with each remodel. Tubs, showers, mood lighting and comfortable spaces for partners to rest were expected in birth spaces. VBACs were encouraged. Mother-baby friendly hospitals were the rule not the exception.

Births in my new community

I recently attended my first series of births near my new home and, while these experiences are only a thumbnail of a much bigger picture, I found the differences in environment to be very stark indeed.  In fact, few of the practices I saw lined up with Lamaze International’s Six Healthy Birth Practices.  I am not a Pollyanna. I know that Archie Cochrane awarded obstetrics the “wooden spoon” in 1979 for being the least evidence based medical speciality.  I have talked with nurses from other states who tell stories about mothers being confined to bed after their water breaks for fear of a cord injury or other such superstitious practices. Still I was surprised at what I saw and have been thinking about the challenges that will face me here as I start teaching childbirth education in my new home.

My intent is not to malign any of the practitioners who I met.  In fact, I found that virtually every staff member that I observed wanted the best for their clients and were trying to make the best of a less-than-ideal situation. To protect confidentiality, I have combined information from several births and changed insignificant details, though I have not fictionalized any of the practices.

Healthy Birth Practice 1: Let labor begin on its own & Healthy Birth Practice 4: Avoid interventions that are not medically necessary

My client had some complications and I believe most practitioners would agree that the benefits of an induction outweighed the potential drawbacks. While I have no issue with that, I question why a provider would offer to break a mother’s amniotic sac when she was only 3cm and clearly not in labor.  There was no discussion of possible complications, no discussion that this practice sometimes slows labor or does nothing rather than speeds it up (Smith, et al 2013.)  AROM did nothing to progress my client’s labor and after 9 hours and 5 vaginal exams, she spiked a fever. This led to antibiotics, Tylenol and a spiral of other outcomes that I will address later.

Healthy Birth Practice 2: Walk, move around and change positions throughout labor

My client wanted to move around in labor but was being continuously monitored.  Her window-less room measured 10’ by 8’. She and her family spent a full 24 hours in this room. No one offered a telemetry unit which would allow her greater mobility and when she asked, was told that the L&D floor had one telemetry unit, but the cord to connect the device to the EFM machine was missing. My client requested to shower, and the only shower on the floor was down the hall, none of the rooms had their own.  Showers were also not allowed when Pitocin was being used.

Healthy Birth Practice 3: Bring a loved one, friend or doula for continuous support

I have to say on this point the facility did pretty well. Like most hospitals, they had a practice of only allowing one support person in the room when an epidural is being administered and during cesarean birth.  My client had her epidural reinserted repeatedly.  I was only asked to leave the room once and was allowed into the surgery after much pleading and crying by the mom.

Healthy Birth Practice 5: Avoid giving birth on your back and follow your body’s urges to push

My client was asked to do a “pushing trial” to see if the physician could reduce the anterior lip that seemed to be holding up progress.  She pushed on her back as that was the only position her provider was comfortable with and, as you will see below, she was unable to support herself in other positions.

After 24 hours, we did end up in a room that had its own toilet.  Few other rooms did.  None of the rooms had a tub and clients were not allowed to bring one in.  The standard was communal bathrooms for women in labor, one shower for the entire unit and no refrigerators anywhere to store patient food for use during labor.

It was my client’s intention to hold off on pain medications until after six centimeters (active labor.)  We were creative but a 24 inch movement radius, lack of access to a tub or shower and continuous pitocin led to an epidural earlier than planned. There were some complications with the block and it needed to be replaced several times, and the final medication level was so significant that the mother had absolutely no ability to move her legs on her own at at all.

Healthy Birth Practice 6: Keep mother and baby together – It’s best for mother, baby and breastfeeding

I already gave away the ending – this mother gave birth by cesarean section.  The operating suite was a fairly good size and I was allowed in the operating room as a doula.  Baby was born immediately yelling and pinking up.  Mom got to see her newborn over the blue screen but baby was immediately brought to the warmer.  I heard the pediatrician say “This baby looks so great I am going to leave!” Even with all of that, routine procedure was for baby to be recovered in a separate room.  Staff would give baby all of her injections, weigh and measure her and bathe the baby before returning the baby to mom’s recovery room.  Standard procedure.  Baby was away from her for a full hour before they had any more than a cursory hello.

After the birth, my client asked that I let her family know that she and the baby were healthy.  The extended family seemed very calm when I told them the good news.  They were unconcerned because they had already seen the baby.  I turned around to see into the nursery where one of the grandmothers was cuddling the baby in a rocking chair.  The extended family was holding the baby before the mother.

Thoughts for the future

Upon leaving, the attending physician told my client, “There is no reason for you not to have a vaginal birth next time.  Just not here.”  Apparently, there has been no change in policy about VBACs even with the recent change to the ACOG guidelines (ACOG, 2010).  This hospital has a VBAC ban.

I am not trying to demonize the health care providers or nurses.  I don’t believe that anyone enters maternity work with the idea of oppressing women.  I do believe they were doing the best they could within this system.  This hospital does have plans to address the facility issues but those will take quite some time and hundreds more women will labor and birth before those changes are made.  Probably more important, I wonder how long it will take for a cultural shift even with floor plan improvements.

Jerome Groopman, M.D. in his book How Doctors Think discusses at length how medical providers – and really all of us – make the same errors of logic and repeat them over and over.  So, while I am all for cheerleading and encouraging parents to advocate for themselves, ask for change in the system, understand the evidence for various practices, I also know that most people have a hard time hanging onto their personal power in a medical setting having been socialized to defer (see another Jerome Groopman book, Your Medical Mind) to their provider.

I am much more interested in preparing parents with real world expectations about what practices actually take place in their local birth community. The childbirth classes that I teach here will by necessity be different from what I taught in Seattle. Best practices are just that, but navigating the realities of what is and still having a positive birth experience vary from locale to locale.

To truly prepare parents, it is imperative that I include curriculum about what really makes up informed consent.  Research may tell us one thing, but choice of provider, provider’s preferences and the personal values of the birthing woman all figure into what makes up this slippery thing called “informed consent.” I have found that many expecting parents have never made a health care decision together and have never discussed their values around health care.  Exploring values and how they relate to medical decision making must also be included in childbirth classes to adequately prepare parents. This self-knowledge is not limited to the labor as it will serve parents well as together they navigate future medical decisions for their child.

And finally, parents need concrete tools and classroom practice talking to providers about their wants and desires.  ‘What the brain fires it wires,’ neuroscience tells us. By tools, I mean a concrete list of conversation starters. For example, “I hear what you are suggesting.  I would like to tell you a bit more about where we are coming from.  We would like delayed cord cutting because we value an unrushed separation)” (James, et al, 2012). The role play speaking values and truth in a safe classroom environment can help make parents more likely to actually do this during the stress of prenatal visits and labor ( Arrien, 1993).

I am so grateful that I get to work as both a doula and a childbirth educator.  I gain so much information from each role that helps improve my work when I am wearing the other hat. I know that not every childbirth educator can attend births but I would encourage educators who can, to do so, and also to work in concert with doulas and other childbirth professionals to find out what is really happening in their area.  Additionally, surveying past students to find out if our presented curriculum addressed the real needs of parents as they progressed through labor can help educators to adapt what we teach to meet those needs.

I am confident that the families that I work with both as a childbirth educator and a doula will benefit from my experiences of what is possible and together we can encourage change to practices that are more in line with best practices in obstetrical care.

References

Arrien, A. (1993). The four-fold way: walking the paths of the warrior, teacher, healer, and visionary. New York, NY: Harper.

James, K., Levy, L. (2012, October). Doubters, believers and choices, oh my. Concurrent session presented at the Lamaze International Annual Conference, Nashville, TN.

Smyth RMD, Markham C, Dowswell T. Amniotomy for shortening spontaneous labour. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD006167. DOI: 10.1002/14651858.CD006167.pub4.

Vaginal birth after previous cesarean delivery. Practice Bulletin No. 115. American College of Obstetricians and Gynecologists. Obstet Gynecol 2010;116:450–63.

About Laurie Levy

Laurie LevyLaurie Levy, LMP, MA, CD(DONA), CD(PALS), CBE is a licensed massage practitioner, birth doula and childbirth educator, human anatomy and physiology instructor, and mother of three rambunctious boys.  Laurie has presented at the 2011 Lamaze InternationalConference and hopes to sit for the LCCE exam in 2014.  She can be reached through her website, laurielevy.net

Childbirth Education, Evidence Based Medicine, Guest Posts, Healthy Birth Practices, informed Consent, Maternity Care , , , , ,

Science & Sensibility Wants You to Write for our Blog!

January 14th, 2014 by avatar
image: aimislam.com

image: aimislam.com

My name is Sharon Muza, and I am the current Community Manager of Lamaze International’s blog Science & Sensibility. In this capacity, I would like to extend an invitation to all of you, to consider becoming a contributor to Science & Sensibility.  I would like to ask each of you reading today, to consider sharing your wisdom, your expertise and your experiences with all of the Science & Sensibility community.  Science & Sensibility is a multi-disciplinary blog launched in April 2009 by Lamaze International to improve knowledge of evidence-base maternity care among Lamaze Certified Childbirth Educators and other birth professionals and advocates.  It is one of the leading online resources for up-to-date news and analysis of research and policy issues affecting childbearing women.

Our mission on this blog is to share research about healthy pregnancy, birth and postpartum, We do this by:

  • Presenting new research and helping readers to better understand the information
  • Reviewing books and films on topics relevant to the field of infant and maternal health
  • Interviewing experts that we all want to hear from, on relevant topics
  • Sharing innovative and effective teaching ideas
  • Introducing resources and tools that readers can use to do their jobs more effectively

Our readership consists of Lamaze Certified Childbirth Educators, other perinatal educators, midwives, doulas, lactation consultants, nurses, doctors, therapists, counselors and consumers from around the world.  I can tell you, after doing this job for almost two years, that our readership loves to engage, learn and participate in process improvement to work towards safer and healthier births for all women and babies.

What is your area of expertise?  What topics are you an expert in?  What is your area of research that you want us all to know about?  Do you enjoy breaking down studies in order to better understand them?  What are you doing to help mothers and babies?  Do you have ideas that you are just bursting at the seams to share?  If so, I invite you to contact me so we can discuss potential opportunities for contributing to the blog.

The list of past and current contributors is diverse and consists of many experts and leaders in a variety of fields. It also consists of a lot of regular people, like you and I, who have something important and different to share.  Everyone likes to learn and grow by being exposed to new information and ideas.  I am happy to offer editing support and other assistance to help you, if you having something to share but are hesitant about writing.official experts

If you enjoy putting pen to paper (or fingers to keypad, as that is what really happens today) and sharing thoughts and information on topics relevant to this blog, I would be delighted to hear from you.  If you have ideas for future posts or topics that you would like to see covered (by someone else), I would love to hear from you. I am happy to find just the right expert to do the job.  If you have suggestions on how we can continue to share research and evidence based practices with all those working to improve outcomes during the childbearing year, let me know.  I would be delighted to introduce our readership to some fresh voices, new ideas and perspectives on the topics that matter to us all.

Won’t you consider becoming a contributor to the blog, or sharing your ideas that help shape our future topics?  We are looking for those who will submit one post and others who want to join our regular contributor panel, offering wisdom on a regular basis.  I extend a warm invite to you and look forward to your responses.  Please reach out to me now.

Childbirth Education, Lamaze International, New Research, Research, Science & Sensibility, Uncategorized , , , , ,

Book Review: Traumatic Childbirth and an Interview with the Author – Cheryl Beck

January 9th, 2014 by avatar

By Walker Karraa, PhD

It is thought that traumatic childbirth affects up to 34% of all birthing women, but frequently there is inadequate prenatal preparation for what to do if an individual woman has this experiences and scant resources for women seeking support and help.  The experiences are minimized and our society creates a fence of isolation that women with birth trauma are surrounded by.  Today, Walker Karraa, PhD reviews a new book geared for professionals and interviews the author, Cheryl Beck, DNSc, CNM, FAAN,  so that we can be better prepared to recognize trauma, support women and provide resources. What are you doing as a birth professional and childbirth educator to help women who may be at risk or or who have experienced birth trauma? – Sharon Muza, Science & Sensibility Community Manager

 …a fascinating and full-bodied presentation of the emerging understanding of the impact of traumatic childbirth on mothers, fathers/partners, and providers.

Traumatic Childbirth1 should be required reading for any birth professional. The trifecta of midwife, pre-eminent researcher and Distinguished Professor at the School of Nursing, University of Connecticut, Cheryl Tatano Beck, clinical nurse specialist in psychiatry, psychotherapist and author Jeanne Watson Driscoll, and survivor, activist and founder of TABS Sue Watson, provides the most comprehensive resource on traumatic childbirth for health professionals to date.

© Cheryl Beck

© Cheryl Beck

Since Cheryl Beck’s ground-breaking research, Birth trauma: in the eye of the beholder2 (2004a), health providers, researchers, and birth professionals have applauded the relevance and strength of Cheryl Beck’s research regarding traumatic childbirth. Her research has covered PTSD following traumatic childbirth3-4, the experience of the anniversary of birth trauma5, breastfeeding after a traumatic birth6, subsequent birth after a previous traumatic birth7, secondary trauma experienced by labor and delivery nurses exposed to traumatic birth8, and multiple publications on research methods and birth trauma 9-12.

In 2006, Cheryl and Jeanne Watson Driscoll (co-author of the landmark Women’s moods: What every woman must know about hormones, the brain, and emotional health13) collaborated on what is still considered a clinical tour de force in perinatal mood and anxiety disorders, Postpartum mood and anxiety disorders: a clinician’s guide14.

TABS (Trauma and Birth Stress) was founded by Sue Watson and colleagues in 1998 and continues to offer current resources and support regarding traumatic childbirth.

In Traumatic Childbirth, Cheryl, Jeanne, and Sue offer their individual expertise as researcher, clinician, and activist and combined wisdom of nearly two decades of work in the field. The result is a compelling read and review of current literature. The case studies are profound examples of the lived experiences of traumatic childbirth. Additionally, after each case Jeanne and Sue offer their own perspectives. It is a fascinating and full-bodied presentation of the emerging understanding of the impact of traumatic childbirth on mothers, fathers/partners, and providers.

I am honored to have had the opportunity to ask Cheryl some questions for Science and Sensibility regarding how childbirth professionals might use Traumatic Childbirth in practice. I know that you will find her insights both useful and encouraging.

Walker Karraa: How has the definition of traumatic childbirth evolved since you began your work?

Cheryl Beck: In the beginning of my research traumatic childbirth was viewed as an event that occurs during labor and delivery that involved actual or threatened serious injury or death to the mother and or her infant. After my first 2 studies on birth trauma and its resulting PTSD what I learned was that traumatic childbirth can also occur even if a woman does not perceive that she or her infant is at risk for serious injury or death. Women can perceive their birth as traumatic if they perceive that they were stripped of their dignity during the birthing process.

WK: How does loss of dignity play a role in the traumatic birth?

CB: One of the most frequent phrases I hear mothers using to describe their traumatic their birth to me was “I felt raped on the delivery table with everyone watching and nobody offering to help me.” Some women shared that they felt like a piece of meat on an assembly line. Women did not feel cared for by the obstetrical team. To me this lack of caring stripped women of a protective layer during their labor and delivery and left them prime to perceive their birth as traumatic.

WK: How important is it for childbirth professionals to understand the subjective experience of childbirth trauma when working with clients?

CB: It is essential for childbirth professionals to hear and really listen to the voices of mothers as they describe what it was about their labor and delivery that was so traumatic. As the title of my first research study tried to impress upon health care providers, birth trauma is in the eye of the beholder. What one woman perceives as a traumatic birth may be viewed quite differently through the eyes of obstetric staff that may see it as a routine birth.

WK: What are some of the ways childbirth educators, doulas, and lactation consultants might use Traumatic Childbirth in developing curriculum or direct service to clients?

CB: Childbirth educators, doulas, and lactation consultants can use the various chapters in Traumatic Childbirth to develop a series of classes for education. Examples of some of these chapters in the book include:

  • Risk factors for postpartum posttraumatic stress
  • Assessment and diagnosis
  • Instruments to screen for PTSD
  • Impact of traumatic childbirth on breastfeeding
  • Anniversary of birth trauma
  • Subsequent childbirth after a previous traumatic birth
  • Treatment methods for PTSD
  • Fathers and traumatic childbirth

WK: As doulas are increasingly becoming a part of birth team, they too are exposed to traumatic births that may lead to distress, impairment and disability in their work. Given the findings in your recent study11 regarding secondary traumatic stress for labor and delivery nurses, I wonder what your thoughts are regarding how doulas might prepare, or even prevent secondary trauma for themselves using Traumatic Childbirth?

 

© Cheryl Beck

© Cheryl Beck

CB: In 1989 Charles Figley15  first wrote about the “cost of caring” for supporters of traumatized victims. He called it secondary traumatic stress or compassion fatigue. Doulas who have built up such a close relationship with the women they are supporting through labor and delivery certainly are at risk of developing secondary traumatic stress. Continuing education is a must for doulas to learn about their risk of secondary traumatic stress and the symptoms they should be watching. Self-awareness of these symptoms is essential so that doulas can get the help they need. Doulas need to learn how to nourish their mind-body-spirit. Debriefing sessions, support groups, and opportunities for doulas to share the traumatic childbirths they have been present for are necessary.

WK: I so appreciate the inclusion of fathers in your book. When I was practicing as a doula I had several fathers who they themselves had risk factors for traumatic stress due to experiences in military or law enforcement. Knowing that upfront, we were able to strategize labor and birth in ways to mitigate exposure to triggers (i.e. < seeing too much blood, not being able to see an open door, etc.). How could Traumatic Childbirth help childbirth educators include partners in the conversation about traumatic childbirth?

CB: Researchers are finding that fathers can also develop posttraumatic stress symptoms as a result of being present at their partner’s traumatic childbirth. This possibility for fathers should be address in one of the childbirth classes. As one father in a research study of mine and Sue Watson’s shared “I am on an island watching my wife drown and I don’t know how to swim! I not only do not know how to swim but I was drowning myself. But I am a man, I do not need help-John Wayne, you know. I was fooling myself at the expense of my wife and myself.” This quote impresses on childbirth educators their responsibility to also be helping the fathers and support them if he and his partner have experienced a birth trauma.

WK: One of the things I note is that we don’t yet have support systems within childbirth organizations to help our childbirth educators and doulas seek support for themselves, or colleagues who suffer extreme distress after attending traumatic births. This is particularly devastating for new doulas who may not know their own risk factors, or the signs and symptoms of traumatic stress following exposure to traumatic childbirth. What are some ways childbirth organizations such as Lamaze can use Traumatic Childbirth to inform policy and prevent secondary traumatic stress in doulas and childbirth educators?

CB: At the annual conferences of these organizations, workshops, sessions, or keynotes on secondary traumatic stress due to traumatic childbirth are a must. The first step in helping to prevent this or minimize secondary traumatic stress is education. Breakout sessions at the conferences could be offered by a mental health care professional for doulas, lactation consultants, and childbirth educators to provide an opportunity for them to share their traumatic experiences.

Conclusion

For those who have followed the research on traumatic birth, this book has been a long time coming! Traumatic Childbirth is a highly readable, compelling and comprehensive collection of research, practice, and perspective that speaks to the birth professional’s sensibilities. I highly encourage the discussion of implementing this material as required reading, and instituting the suggestions of debriefing workshops for professionals. I look forward to hearing your thoughts on this, as well as the book!

I know I speak for so many in thanking Cheryl Beck for her input, and to both Jeanne Driscoll and Sue Watson for their tremendous contributions in Traumatic Childbirth, and their dedication to the prevention and treatment of traumatic birth.

References

  1. Beck, C. T., Driscoll, J.W., & Watson, S. (2013). Traumatic childbirth. New York, NY: Routledge.
  2. Beck, C. T. (2004). Birth trauma: in the eye of the beholder. Nursing research, 53(1), 28-35.
  3. Beck, C. T. (2004). Post-traumatic stress disorder due to childbirth: the aftermath. Nursing Research, 53(4), 216-224.
  4. Beck, C. T. (2011). A metaethnography of traumatic childbirth and its aftermath: Amplifying causal looping. Qualitative Health Research, 21(3), 301-311.
  5. Beck, C. T. (2006). The anniversary of birth trauma: failure to rescue. Nursing research, 55(6), 381-390.
  6. Beck, C. T., & Watson, S. (2008). Impact of birth trauma on breast-feeding: a tale of two pathways. Nursing Research, 57(4), 228-236.
  7. Beck, C. T., & Watson, S. (2010). Subsequent childbirth after a previous traumatic birth. Nursing research, 59(4), 241-249.
  8. Beck, CT, & Gable, RK (2012). A mixed methods study of secondary traumatic stress in labor and delivery nurses. Journal of Obstetric Gynecological and Neonatal Nursing, 41, 747-760. doi:10.1111/j.1552-6909.2012.01386.x
  9. Beck, C. T. (2005). Benefits of participating in Internet interviews: Women helping women. Qualitative health research, 15(3), 411-422.
  10. Beck, C. T. (2006). Pentadic cartography: Mapping birth trauma narratives. Qualitative Health Research, 16(4), 453-466.
  11. Beck, C. T., Gable, R. K., Sakala, C., & Declercq, E. R. (2011). Posttraumatic Stress Disorder in New Mothers: Results from a Two‐Stage US National Survey. Birth, 38(3), 216-227.
  12. Beck, C. T. (2009). Critiquing qualitative research. AORN journal, 90(4), 543-554.
  13. Sichel, D., & Driscoll, J. W. (1999). Women’s moods: What every woman must know about hormones, the brain, and emotional health. New York: William Morrow.
  14. Beck, C. T., & Driscoll, J. (2006). Postpartum mood and anxiety disorders: A clinician’s guide. Jones & Bartlett Learning.
  15. Figley, C. R. (Ed.). (1989). Treating stress in families (No. 13). Psychology Press.

 

 

 

Birth Trauma, Book Reviews, Childbirth Education, Guest Posts, Trauma work , , , , , ,