Science & Sensibility

PR News announced this week that Lamaze’s Push for Your Baby campaign was a co-winner for the 2013 Nonprofit PR Award for Digital PR and Marketing.

The Push for Your Baby campaign worked to provide expecting mothers with key information they needed to push for a safe and healthy birth for their baby. According to PR News, “the campaign launch successfully positioned Lamaze as a go-to resource for maternity care information and generated excitement among its educators.”

Within a week of launch, the campaign’s online video received over 1,000 views, and overall the campaign yielded more than 18 million earned media impressions. To date, the video has had over 8,400 views. Lamaze would like to thank Jones Public Affairs for their work on this campaign and leading the implementation.

Science & Sensibility first wrote about the “Push for Your Baby” in the blog post: New Lamaze Campaign: Push for Your Baby! Childbirth Educators Play a Key Role.

Are you using this wonderful video and accompanying materials to reach your students with the message that parents can push for a safe and healthy birth?  What has been the feedback from your classes on this material?  If you are not using it, won’t you consider incorporating this fantastic resource in your class curriculum?

You can read more about this award from PR News.

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The Lamaze abstract deadline is right around the corner! Lamaze International invites you to share your knowledge and research at the 2013 Lamaze Annual Conference, Let the Good Times Roll for Safe and Healthy Birth by submitting an abstract by March 11! The Lamaze Conference Committee is seeking presenters that can build transferable skills among conference attendees through their presentations and hands-on learning sessions. This year’s Annual Conference will focus on four key elements that are significant to childbirth professionals: Business and Technology Practice for the Childbirth Educator Evidence Based Teaching and Practices Innovative Teaching Techniques New and Emerging Research in the Field of Childbirth Education Share your knowledge and experience with other maternity care professionals and benefit from professional development and interaction with colleagues. Do you want to share your research AND save money? Then submit your abstract for a poster presentation before it’s too late! Lamaze International understands the importance of sharing research, and ideas to advocate for safe and healthy birth. By submitting an abstract for a poster presentation, you will be able to share your research, classroom experiences or advocacy methods and develop a personal connection with other childbirth educators and attendees that will enhance your overall Lamaze experience. Posters are a great way to: Share the outcomes of strategic initiatives in your hospital Demonstrate ways in which you enhanced your business Explain ways in which you advocated for safe and healthy birth in your community Along with the chance to gain recognition for your work among colleagues, you will also receive a $45 discount on your registration fee if your abstract is accepted! Submit your abstract for a poster presentation by March 11 or miss out on an invaluable opportunity to connect with others while you save! Review abstract submission guidelines and category descriptions on the Lamaze Website. Questions? Email speakers@lamaze.org , or call 202-367-1128 with any questions about the abstract submission process.

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Regular contributor Penny Simkin discusses the research around parents’ singing to their babies in utero and the post birth benefits.  She also shares how birth professionals can encourage clients, patients and students to start this practice during pregnancy.  Part one of this two part series can be found here. – Sharon Muza, Community Manager, Science & Sensibility

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What is the research evidence for postnatal benefits to parents or babies  of singing to the baby before birth?

• Fetuses can sense audio vibrations and rhythms early in pregnancy. Later in pregnancy they hear and distinguish various sounds. (4)
• They recognize their parents’ voices after birth (1)
• Newborns prefer their parents’ voices over the voices of strangers (1)
• Repetitive prenatal reading of one story by one parent every day for weeks results in the newborn’s recognition of and preference for that story. (2)
• Fetuses respond to music by calming, becoming active, changes in FHR (depending on the music) 5,6)
• Premature babies are calmed by calming music. (7)
• Newborns and young babies are calmed by familiar music, as demonstrated by the universal use of lullabies.

Combining these findings, a proposal

In light of all that has been learned about babies, I think we can combine it all into a simple approach to enhance bonding, soothe the baby, empower parents with their own unique tool that no one else, even the experts, can do as well as they. (8) I propose that we who provide care and education for expectant parents urge them to do the following at around 30-32 weeks’ gestation (or earlier or later):

Maia sings to her sister in utero ©Penny Simkin

If parents feel they can’t sing or are too embarrassed to do it, I suggest choosing a poem that has a nice rhythmic meter, and recite that to the baby. I recommend Mother Goose Rhymes or poems in books by AA Milne, such as “When We Were Very Young” and “Now We Are Six;” or Shel Silverstein’s “Where the Sidewalk Ends” and others.

Film clips showing baby’s reactions to familiar songs 

Recent students in my birth class took my suggestion to heart, singing “Las Mañanitas,” from their Mexican culture, to their unborn baby frequently. The dad would lie with his head on the mother’s pregnant belly as they sang. They even videotaped sessions while the mother was having a non-stress test that showed the baby’s heart rate steadying when the dad was singing, and rising when he was not.  We also see the dad singing to their sweet little daughter right after the birth. Though she cries pretty hard when being suctioned and rubbed with blanket, she calms down with his singing.

I’ve just completed a film for children (9). In the film, we see 4 year old Maia singing  ”Twinkle, Twinkle, Little Star” to her baby sister before birth and again right after birth. Neve, her sister, calms down when she hears Maia singing the familiar song.

Enjoy these heartwarming scenes in the video below.

Conclusion

Maia sings to her newborn sister ©Penny Simkin

In conclusion, when parents sing one (or possibly a few) songs repeatedly to their child, before and after birth, it is a once in a lifetime opportunity to build a unique, meaningful and fun connection with their baby. The child already knows and loves the song as sung by his/her parents more than any other song, sung by anyone else. Parents always have their voice with them and can use it to comfort, soothe, and play with their child for years to come. Parents have the opportunity prenatally to give their baby a gift that becomes a gift for them as well.

Singing to the baby before and after birth is a lovely and very special thing to do. Would you consider introducing this ritual to your students, clients and patients?  Have you already done so?  How has it been received?  Do you have any stories about parents who have practiced this connection? Please share in the comments section, I would love to hear about it.  If we all get the word out to expectant families, it could have a very positive impact.

References:

1.  Brazelton B. Cramer B. (1991)The Earliest Relationship: Parents, Infants, and The Drama Of Early Attachment . Da Capo Press Cambridge, MA.
2. De Casper A. 1974, as described in Klaus M, Klaus P, Kennell J. 2000. Your Amazing Newborn. Da Capo Press, Cambridge, MA..
3. Odent M. 1984, Birth Reborn. Pantheon Books: New York
4. Klaus M, Klaus P, Kennell J. 2000, Your Amazing Newborn. Da Capo Press, Cambridge, MA.
5. Verny T, Kelly J. (1982)   The Secret Life of the Unborn Child. Dell: NY
6. Chamberlain D. (2013) Windows to the Womb. North Atlantic Books: Berkeley, CA.
7. Lubitzky R, Mimouri F, Dollberg S, Reifen R, Ashbel G, Mandel D. 2010. Effect of music by Mozart on energy expenditure in growing preterm infants. Pediatrics 126;e24-e28. DOI: 10.1542/peds.2009-0990.
8. Simkin P. (2012) Singing to the baby before and after birth.  International Doula 19(3):30-31
9. Simkin P. (2013) “There’s a Baby: A Children’s Film About New Babies.” PassionflowersProductions: Seattle.

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Regular contributor Penny Simkin shares her experiences with parents who sing to their baby in utero and then continue after birth and looks at what the research says about this practice in this two part blog piece.  Part two can be found here. Join me in reading about some unique situations that Penny shares as she explores this opportunity for parents to bond with their unborn child.  - Sharon Muza, Science & Sensibility Community Manager.

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People have sung to their babies forever. Every culture has lullabies and children’s songs that are passed down through the generations. New ones are written and shared and the custom goes on –a rich part of the fabric of human civilization. These songs are designed to relax babies, calm their fears, or entertain and amuse them throughout childhood. As we have learned more about the life and capabilities of the fetus, we have realized that the fetus can hear clearly for months before birth, and also can discriminate sounds and develop preferences for some sounds over others. Furthermore, at birth, newborns respond to familiar sounds by becoming calm and orienting toward the source of the sound, and even indicate their preferences for familiar voices and words over the unfamiliar.

Newborn babies prefer their parents’ and other familiar voices over those of strangers (1), and they prefer hearing a story that their mother had read frequently in utero rather than an unfamiliar story or the familiar one read by someone other than their mother (2).  Fetuses hear, remember, have preferences, respond to, and discriminate among differences — in sounds, music, voices.

These exciting findings have inspired educators to advocate prenatal learning through recordings played through a mother’s abdomen (of languages, music, and other things). They have inspired birth activists and baby advocates to provide a safe enriching environment for the fetus. Advocates of prenatal bonding emphasize communication between parent and unborn child as a powerful way to strengthen the bond.

I’d like to offer my take on this phenomenon and urge everyone who works with expectant parents to tell them about some unique and heart-warming benefits of singing or reciting rhymes to their unborn babies.

I think my interest in parents singing to their babies prenatally began in the 1980s when I first read Michel Odent’s book, “Birth Reborn”(3). Odent is a French physician who has always been ahead of his time. He had a unique and original maternity care program at his hospital in Pithiviers, France. His book had a great influence on my understanding of normal birth, and the book is still worth reading today, along with all his subsequent ones. One lovely aspect of his program is particularly relevant to the topic of this blog post. The program included a weekly singing group at the hospital, attended by pregnant women, their partners, families with young babies, the midwives, and Odent himself. The group was led by an opera singer who believed singing to be important for fetuses, babies and those who care for them. Odent’s account inspired me to invite Jamie Shilling, a folk singer who had recently taken my birth class, to bring her guitar and her baby to my classes a half hour early each week and sing with the expectant parents. That went on very successfully for several class series, then the groups decided to combine and carry on in a monthly sing- along for expectant parents and new families, in a private home –Although the groups  eventually disbanded, they provided many parents with opportunities to sing together and connect with their babies and each other in relaxing and peaceful surroundings. A high point during that time was when Michel Odent came to Seattle to give a conference and he agreed to come to one of our sing-alongs. See the photo of Jamie leading the group of expectant and new parents, with Michel Odent and myself participating. He taught us the song, “Little Black Cat” in French.

© Penny Simkin

I couldn’t help but think during those times, how the unborn and new babies must love hearing their parents singing. Seeing the parents caressing the mother’s belly as they sang was heartwarming. That happened  in the mid- 1980s, when much research on the capabilities of the unborn and newborn baby was beginning to be published. Recalling those special gatherings, I have always suggested to my students in childbirth class that they sing to their unborn babies, or play their favorite recorded music, with the thought that the baby will remember it and be soothed by it after birth.

But it was one couple, whom I served as a birth doula, who took my suggestion to another level, and showed me much more about the value of singing to the unborn baby. They were having their second child, hoping for a VBAC. When they discovered that they were having a boy, they decided to give their baby the song, “Here Comes the Sun” and sang it to him often during pregnancy. The VBAC was not possible, and as the cesarean was underway, and the baby boy, crying lustily, was raised for the parents to see, the father began belting out the baby’s song. Though the mother didn’t have a strong voice under the circumstances, she also sang. The baby turned his head, turned his face right toward his father and calmed down while his father sang. Time stopped. As I looked around the operating room, I saw tears appear on the surgical masks.

It’s a moment I’ll never forget, and it was that event that taught me the value, not only of singing prenatally, but also, singing the same song every day. Not only does the baby hear his or her parents’ voices, not only does he or she hear music, but the baby also gets to know one song very well. Familiarity adds another feature to this concept, because we know that fetuses have memory and prefer the familiar. Think for a moment about what this might have meant to our cesarean-born baby –suddenly being removed from the warmth, wetness, and dimness of the womb with its mother’s reassuring heartbeat, into the cold bright noisy operating room. The baby’s transition to extrauterine life is hectic and full of new sensations. He cries reflexively, but perhaps also out of shock and discomfort. Then he hears something familiar – voices and music and the sounds of words that he has heard many times before – something he likes. He calms down, and seeks the source of this familiar song. Everyone present is moved by this gift to the baby from his parents.

I’ve become passionate about this idea as a way to enhance bonding between parents and babies, but also as a unique and very practical measure for soothing a fussing baby or a sick baby who can’t be held or breastfed. Please join me on Thursday, for Part Two on this topic when I will continue the discussion including research evidence that supports this concept: practical suggetions for childbirth professionals to share with expectant parents; and some very endearing film clips of families singing to their babies.

References:

1. Brazelton B. Cramer B. (1991)The Earliest Relationship: Parents, Infants, and The Drama Of Early Attachment . Da Capo Press Cambridge, MA.

2. De Casper A. 1974, as described in Klaus M, Klaus P, Kennell J. 2000. Your Amazing Newborn. Da Capo Press, Cambridge, MA.

3. Odent M. 1984, Birth Reborn. Pantheon Books: New York 

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“Our goal is not to have every mother birth at home—our goal is to encourage parents to gather quality information, to gain exposure to a philosophy that screams trust in mothers and trust in babies, and to provide parents who do plan a homebirth to be well equipped with an understanding of how to thrive in that decision.” – Jane E. Drichta, CPM and Jodilyn Owen, CPM, authors of The Essential Homebirth Guide: For Families Planning or Considering Birthing at Home.

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The Essential Homebirth Guide: For Families Planning or Considering Birthing at Home by midwives Jane E. Drichta, CPM and Jodilyn Owen, CPM  is a new book on the birth scene, being released today both in print and as an e-book.  I had an opportunity to read an advanced copy and and will share my thoughts with Science & Sensibility readers in this review.

The Essential Homebirth Guide is a book that is long overdue and will be welcomed by consumers and healthcare providers alike. With the recent National Birth Center Study II  released last month, many women and their families may now be considering an out of hospital (OOH) birth.  Some areas of the US offer the opportunity to birth in a birth center, while other parts of the country have no birth centers available at all and homebirth is the only OOH option.  Even where birth centers are available, women in greater numbers are now considering birthing in their own homes, with midwives, for many reasons, including comfort, cost and choosing a location where they feel they have the best chance to achieve a low intervention birth.

Sitting down to read Drichta and Owen’s guide is like spending a long weekend with your very best friend.  A best friend who just happens to be a midwife.  Whether you are just starting to explore the idea of a homebirth or have already decided that homebirth is for you, you will find that all your questions get answered in an easy to understand, factual way, with all the details and inside information that only your best friend can provide.  Drichta and Owen even provide answers to the questions you hadn’t thought of yet, but would want to know if you choose to homebirth, such as the section on communicating your homebirth choices with friends and family.

The book is arranged into chapters, and then subtopics.  Each subtopic has a nice Q&A format, with all the major questions covered in easy to understand language.  Peppered amongst the topics are real life stories and musing submitted by homebirthing women and their families, as well as special “The Midwife Says:” sections that provide additional information.  The personal stories offer a peek into the thoughts and experiences of homebirthing women, and readers will feel comforted by their stories. References are included for each chapter, and there are several hearty appendices at the back for more information. Lovely black and white pictures are scattered throughout.

One of the things that I loved best in The Essential Homebirth Guide is how the authors use every opportunity to speak to the mother, helping to develop her self-determination.  Throughout the book, they reinforce that every mother knows both her body and her baby best.  Women who read this book will feel confident that they are (or should be) equal partners in their care with their healthcare provider and are capable of asking questions, gathering information and making decisions that feel right to them.

“…A lot happens between the time of conception and diapers, and it all matters.  It will affect you.  It will change you.  It will propel you into motherhood in a profound way and can leave you with feelings of power, health, and peace, or it may leave you with feelings of anxiety, fear, and even trauma.  What kind of emotional context do you want as you become a new mother? What kind of new mother do you aim to be?  Think about these questions first, and then start building your prenatal care to lead yourself down the road that ends with you – the kind of new mother you intend to become in the kind of health you strive to have…” The Essential Homebirth Guide

Jodlilyn Owen, CPM

Chapters on interviewing and choosing a midwife, what to expect during your prenatal care, prenatal testing options, information on the top ten pregnancy issues, preparing to birth at home, and what to expect after the birth all provide details on what normally occurs and include topics that can be discussed with your midwife along with things you can do to keep yourself healthy and low risk. In fact, this book is useful for any pregnant woman, as it will help facilitate conversations with hospital based healthcare providers, to help the woman who has chosen to birth in the hospital avoid unnecessary interventions. 

Drichta and Owen tackle some controversial subjects such as homebirth after a cesarean, home breech birth and homebirth of twins. No doubt, everyone’s comfort level is different and women (and their healthcare providers) process and understand risk in very individual ways.  These situations may not be for everyone, but the authors don’t ignore that these birth situations are occurring at home all around the country.  Information is power, mothers, when given accurate information in a respectful manner, will be able to determine what feels like the right decision for them.

I would have appreciated more information in the book on how low income families and women of color might find their way to homebirth in today’s maternity care climate, as the increase in homebirths has not been observed amongst those populations. Where I live, in the state of Washington, almost half of our births are paid for by the state, and we are fortunate that homebirth is an option for those families receiving state aid.  That is not the case for most of the rest of the country.

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I had the opportunity to ask Jane Drichta and Jodilyn Owen some questions about their book, and wanted to share my interview with Science & Sensibility readers.

SM: Why did you want to write this book, and why now? 

JO: This book has been running around in circles inside of our heads for years.  We make it a habit to check in with each other after most births, and so there are at least a decade of late night conversations here.  As we talked, we realized that we were running into the same problem; there was not one definitive source of information for homebirthing families.  We had websites and articles and handouts, but not one place where we could send parents for unbiased, evidence based information, served up with sides of common sense and love. Homebirth is becoming more and more popular, and the time just seemed to be right. 

SM:  What was the most challenging topic for you to cover in the book? How did you handle it? 

JD: The chapter on The Big Ten, which details ten common complications in pregnancy, was difficult to write.  We are used to speaking around these topics in very technical terms, and it was difficult to distill the information down to what mothers needed to know.  We were more interested in providing a model for how we approach these issues that any woman can adapt to her situation than being prescriptive about what one must absolutely do in a given situation.  When we started that chapter, it sounded like we were writing a term paper.  We completely lost the friendly, accessible tone that we were going for.  So that was a challenge.   

SM: What is the main piece of information that you hope that women will know/take away after finishing your book?

Jane E. Drichta, CPM

JD:  That they can do this.  That birthing at home is a viable option in 21st century America. That the desire to do this doesn’t mean you are crazy or hate the patriarchy, or that any of the other homebirthing stereotypes apply.  Women can birth at home more safely than ever before, and it is a real alternative for most women.

SM: What challenges do you see facing the potential growth of homebirths in the US?

JO:  The integration of homebirth midwives into our current health care system.  The politics around midwifery and its place in the system are myriad, and not something that we wanted to get into in the book.  However, we do support the right of women to birth in the place of their choice, with the provider of their choice, and that is sometimes difficult and can be limiting.

SM: If midwives and doctors read this book, what do you hope they take away from it?

JO: We hope they take away a few key points:  That mothers and partners should be held responsible to seek information and share decision making in their care, that a pregnant and birthing woman is in partnership with her baby and this dyad perspective should be promoted at all times with the language and behavior providers use, and that a woman is never just her numbers—she is a whole human being with a context worthy of their curiosity and respect.  

SM: How can childbirth educators use this book with their students?

JD: Simply presenting this paradigm of woman-centered, individualized, continuous care is a great way to open the door for discussions about creating intention for pregnancy and birth.   What is it that parents really mean to establish for themselves when it comes to their care and birth?  Understanding risk, breaking apart decision-making models, and tuning in to their inner-wisdom are just some of the great tools that educators can work through.

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I wanted to see what the authors had to say about childbirth classes for women considering homebirth and was delighted to find that they encourage all women to take classes and hold Lamaze International and our Healthy Birth Practices in high esteem.  ”We can’t find anything not to love here” is found in the childbirth class section under the Lamaze heading..

Overall, I really enjoyed reading this book and found it to be an easy read and full of information that I would find useful if I was still deciding where to birth or had already made up my mind to birth at home.  I could also see myself referring back to this as my birth got closer.  This book acknowledges that I am the best person to make this very personal decision about where to birth my baby. I think that healthcare providers who offer OOH birth services might want a few copies on their bookshelves to lend to potential and current clients, and childbirth educators might very well recommend this resource to parents in their classes who want to know more about what a home birth might be like.

Please consider coming back to the blog and sharing your thoughts after reading the book.  I would love to know what you think and if you would recommend this to clients and students.  If you would like to contact the authors, they can be reached through their website Essential Midwifery.

Disclosure: The authors of this book and I are all members of the professional birth community in Seattle, WA.  I have known them on a professional and personal level long before this book was even conceived.

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