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Posts Tagged ‘Cochrane Collaboration’

How to Find Birth Evidence – Video Tutorial by Rebecca Dekker of Evidence Based Birth

February 6th, 2013 by avatar

Today, Rebecca Dekker, PhD, RN, APRN of Evidence Based Birth shares a quick but very effective video tutorial on how to use the Cochrane Library to find evidence based information on maternity care topics.  Free and full access to the Cochrane Library is a Lamaze International member benefit and I value the information I am able to find there.  For more information on the Cochrane Collaboration, please see my recent post  celebrating the 20th anniversary of the Cochrane and sharing a bit about the history behind it. 


What other topics would you like covered in a video tutorial?  Rebecca is looking for more suggestions for the next video tutorial!  Also,  let us know how you use the Cochrane Library and please share other favorite sources you also use to find evidence based information on birth topics you are researching.

Childbirth Education, Evidence Based Medicine, Maternity Care, Research , , , ,

Happy 20th Anniversary to the Cochrane Collaboration!

January 15th, 2013 by avatar

As I wrote about in my January 3rd, 2012 post on the top 10 reasons to join Lamaze International, one of the great benefits of being a Lamaze member is complete access to the Cochrane Collaboration.  The Cochrane Collaboration is an international organization whose purpose is to make available information on the effects of healthcare interventions.  Reports in the form of Cochrane Reviews are current, accurate and made available electronically on the internet and by DVD, and updated monthly.  Systematic reviews are conducted and published on a wide variety of healthcare interventions so that people can make informed decisions. This is stored in the Cochrane Library.

Archie Cochrane, photo credit: Cardiff University. Library, Cochrane Archive, University. Hospital Llandough

The Cochrane Collaboration was founded by Archie Cochrane, who was a British medical researcher.  Mr. Cochrane is best known for his article Effectiveness and Efficiency: Random Reflections on Health Services written in 1972.  

The creation of a systematic review of randomised controlled trials (RCT’s) of care during pregnancy and childbirth is “a real milestone in the history of randomised trials and in the evaluation of care.” Professor Archibald Leman Cochrane, CBE FRCP FFCM, (1909 – 1988)

The Cochrane Collaboration is celebrating their 20th anniversary this year, 2013 and will be sharing a series of 24 short videos over the course of the anniversary year, focusing on the ideas, achievements and people that have been part of the history of this international and well-respected organization.  I am sharing the first in this series, so you can learn a bit more about how this organization came to be recognized as the gold standard in evidence-based health care.

The United States Cochrane Center has created and made available free of charge, an online tutorial, “Understanding Evidence-based Healthcare: A Foundation for Action, that can help you to learn how to best navigate and understand the resources contained in the Cochrane Library.

Lamaze International’s Healthy Birth Practice Tools is completely based on evidence based information and was created so that consumers could understand and advocate for the best care for themselves and their babies.  Lamaze recognizes the importance of educators and others having access to up to date information and therefore is pleased to offer access to the Cochrane Library as a member benefit.   To access the Cochrane Library as a Lamaze member, first login to Lamaze International’s Member Center and then follow the drop down box to the Cochrane Library. You will be redirected to the library, with full access.

I rely on and use this member benefit constantly, and appreciate it being made available to me by Lamaze.  Won’t you share in the comments section how you use the Cochrane Library?  How has it helped you?  Do you find what you need?  Do you share information and studies with your students, clients and patients?  Let us know, please.

References 

Cochrane AL. Effectiveness and Efficiency. Random Reflections on Health Services. London: Nuffield Provincial Hospitals Trust, 1972. (Reprinted in 1989 in association with the BMJ, Reprinted in 1999 for Nuffield Trust by the Royal Society of Medicine Press, London (ISBN 1-85315-394-X)

Childbirth Education, Continuing Education, Evidence Based Medicine, Healthy Birth Practices, Healthy Care Practices, informed Consent, Lamaze International, Maternal Quality Improvement, Maternity Care, Medical Interventions, New Research, Practice Guidelines, Research, Systematic Review , , , , , , , , ,

Top Ten Reasons to Become a Member and Join Lamaze International Now!

January 3rd, 2013 by avatar

Did you know that Lamaze International membership runs with the calendar year?  Did you remember to renew your membership at the end of 2012, or did it get lost in the hustle and bustle of the holidays, along with your normal everyday juggle of work, family and self-care?  Have you considered becoming a Lamaze International member but never followed through or were unsure of how it benefits you?  I would like to take a few minutes to share my “Top 10 List” of why it is simply wonderful to be a Lamaze International member, and how I benefit financially and professionally from my membership every day.

1. Supporting the Lamaze International Mission

The mission of Lamaze International is to promote, support and protect natural, safe and healthy birth through education and advocacy through the dedicated efforts of professional childbirth educators, providers and parents.

I am a childbirth professional, working with birthing families, new doulas and new childbirth educators.  I find that Lamaze’s mission aligns so well with my own, and how I create my classes and work with families and birth professionals.  I am proud to say that I am a member of Lamaze and an LCCE.  I think that many of today’s families and birth professionals can also respect and relate to Lamaze’s mission and find that their values are in sync with what Lamaze offers to the maternity world.  Your membership dollars, combined with other members’ financial support help Lamaze to fulfill this very important mission.

2. Journal of Perinatal Education

The Journal of Perinatal Education (JPE) is a quarterly journal mailed to the home of all Lamaze members and is  filled with relevant, current research that can change the way you teach or practice.  The JPE offers you insights into current maternity trends, access to in-depth articles and the opportunity to learn from international experts.  The JPE is read by childbirth educators, doulas, midwives, RNs, Doctors, Lactation Counselors and other professionals. Additionally, as a Lamaze member, you have access to back issues of the JPE online.

3. FedEx Office Discounts

Being a member of Lamaze International allows you to receive a FedEx Office (Kinko’s) discount that has the opportunity to provide you with significant savings.  All of the discounted services that you can receive at the FedEx Office store along with online discounts have the potential to save you more money than your membership costs.  I am amazed at the level of savings on some of the products and services I use for my business printing and shipping needs.

4. Reduced Fees for Lamaze Products and Events

As a member of Lamaze, you receive member discounts when you register for the annual conference, continuing education contact hours, purchase the Study Guide and other Lamaze materials in the Online Education Store, certification materials and test fees for your LCCE or when you recertify for your LCCE.

5. Birth: Issues in Perinatal Care Journal Discounts

Birth is published quarterly and Lamaze members receive a 50% discount on both the hard copy journal and the online journal. Birth: Issues in Perinatal Care is a multidisciplinary, refereed journal devoted to issues and practices in the care of childbearing women, infants, and families. It is written by and for professionals in maternal and neonatal health, nurses, midwives, physicians, public health workers, doulas, psychologists, social scientists, childbirth educators, lactation counselors, epidemiologists, and other health caregivers and policymakers in perinatal care.

6. Your Lamaze Classes Listed on Lamaze Website

If you are a Lamaze Certified Childbirth Educator and a current Lamaze member, your childbirth classes can be listed on the Lamaze International website for parents, in the “Find a Lamaze Childbirth Class” section so that those families looking for a childbirth class can locate your offerings. Increase your class enrollment with this members only benefit.

7. Full Cochrane Library Access

Lamaze International members have full access to the Cochrane Library, a collection of databases containing independent evidence to inform healthcare decision-making.  The Cochrane Library is considered the gold standard of evidence based information and if you are looking for the most up-to-date research on topics relevant to obstetrics and maternity care, breastfeeding and newborn issues, this is the ideal place to find the information you are looking for.

8. Lamaze Forums and Community

As a Lamaze International member, you have member access to our professional forums, on-line communities and discussion groups, where you can share teaching ideas, learn how your peers feel and respond to different topics of interest and collaborate with professionals around the world, from the comfort of your own home or office.

9. Members Only Teaching Resources

When you join Lamaze International, you are provided access to teaching handouts and resources to share with your students, and a variety of class-enriching resources to make your course more relevant, useful and informative to the families that you are working with.

10. Supporting Lamaze Improves Maternity Care Worldwide

LCCEs attend the DONA Conference
Photo Credit HeatherGail Lovejoy

When you purchase a Lamaze membership, Lamaze International can pool your dollars with other members’ dollars and use some of this income to support other organizations that are leading the way in changing maternity care around the world for the better.  Lamaze International supports and collaborates with the Coalition for Improving Maternity Services (CIMS) and others.  Additionally, Lamaze can send personnel to international conferences to represent Lamaze International, create networking opportunities for all of us, collaborate with other maternity leaders and further work to fulfill the mission of Lamaze International and improve birth for women everywhere.

Where else can a membership that costs only $115 ( or less, depending on your country of residence) produce such tangible benefits and savings for you and combine with other membership funds to improve maternity care world-wide?  I am proud and excited to renew my Lamaze International membership every year and invite you to renew yours, if you haven’t already.  If you are not a member of Lamaze, then now is the time to join, so that you can reap the professional benefits for the full calendar year.  For a full list of member benefits , please see the member benefits page on the website. Don’t hesitate, join or renew now!

Can you share how being a Lamaze International member has benefited you? Why are YOU a Lamaze member?  Tell us what it means to you in the comments section.

Journal of Perinatal Education, Lamaze International, Maternal Quality Improvement, Maternity Care, Push for Your Baby , , , , , , , , ,

Lamaze Healthy Birth Practice #3: Bring a Loved One, Friend, or Doula for Continuous Support

February 22nd, 2011 by avatar

Science & Sensibility welcomes new contributor,  Jackie Levine, as she shares with us her thoughts and compilation of the latest industry research about doula care.


Why is Labor Support So Important?

Ordinary intuition informs us, without reference to any study, that human touch and supportive contact, caring and calming behavior, and the sharing of the profound experience of birth with a loved one or close friend can all have powerful and positive effects on a woman in labor.

It turns out, our intuition is correct about the salutary effects of labor support; there is a bulging library of good research that clearly measures and identifies the benefits to mother and baby.

One comprehensive study published in Clinical Obstetrics and Gynecology (Kayne, Greulich, Albers, 2001) presents a thorough history of the doula and of continuous labor support in the US. The study highlights the social and medical rationales for doula care, including a meta-analysis of the research on labor support.  This observation in the study rings particularly true: “Perhaps the greatest lesson to be learned from these studies is that the laboring woman, not hospital policy, should decide who should be present for labor support”.  That thinking harmonizes nicely with the statement of “The Rights of Childbearing Women,” enumerated by Childbirth Connection and quoted in The Official Lamaze Guide: “#15- Every woman has the right to receive continuous social, emotional and physical support during labor and birth from a caregiver trained in labor support”.

Maternity care policies vary from institution to institution and from caregiver to caregiver. This is old news.  In spite of considerable resources spent and the good intent of those caregivers, we know that some models of maternity care involve the overuse of harmful or ineffective but expensive protocols, and the underuse of ones that confer benefit; current care practices do not always reflect the host of systematic reviews that support best-evidence protocols.  The Milbank report, as posted on Childbirth Connection, tells us that, in an analysis of practice bulletins issued by ACOG between 1998 and 2004, only 23% of those practice recommendations were based on Level A evidence (consistent science), 35% were assessed as Level B (inconsistent or limited evidence) and 42% were Level C (based on consensus or the opinions of experts). (Sakala C, Corry M, 2008.)  Those numbers are reflected in the dismal ratings that the WHO gives the US:  we are 49th in maternal mortality and 29th in infant mortality of 141 developed countries (WHO 2006). Clearly, we’re not doing everything right and we all hope to see the day when evidence-based maternity care becomes the standard, replacing the existing welter of practices. But continuous labor support is Level A.

In the recent past, through the 1960s, when “twilight sleep” for hospital birth was the paradigm, women did labor alone, and would awake from their anesthetized slumber the next day, perhaps, and ask “Did I have a boy or a girl?”  There are some women, of course who just don’t want any “company,” who find the intermittent visits from staff and caregivers to be enough interruption of concentration and purpose. These women typically invite their partner or other family members back into the room just for pushing and birth. I have known a very few who labor this way. But for most women, whether first-time mothers or not, continuous support and “company” is a must. The arsenal of data showing improved obstetric outcomes with continuous labor support gives potent ammunition to every mother desiring it. I believe that at this juncture, very few caregivers will deny labor support to the mother.  But that is not enough.  The most effective labor support for mother and family is shown to be provided by the “paraprofessional the doula ”(Lantz,Low,Varkey, Watson, 2005).

Paying a doula fee is out of the reach of many, but several recent developments will make doula care increasingly accessible. Hospital-based programs that supply doulas to laboring women are few and far-between, but some insurance companies will now reimburse part of a doula’s fee. And it’s heartening, that the need for “paraprofessional” labor support is now understood by those in government to be a vital part of good maternity care, evidenced by President Obama having signed an Omnibus bill in December which included 1.5 million dollars that The Health Resources and Services Administration (HRSA) will distribute to support community-based doula training programs on a grant basis.  The Kayne study asserts that even in active management of labor “continuous professional support is considered the most effective in reducing operative deliveries” (Kayne, Greulich, Albers, 2001). The rationale for doula care for all is further bolstered by the latest (2011) review from the Cochrane Database: Continuous Support for Women during Childbirth (Hodnett, Greulich, Albers, 2011).  There is no question that doula support results in healthier mothers and babies, and safer labors and births.

How can we, educators, doulas, friends and family of birthing women, encourage, convince and facilitate this Healthy Birth Practice?  In 2005, the Journal of Perinatal Education published a study on community-based doulas, advising childbirth educators in sum to act as advocates, and “catalysts in their community to initiate highly personal support services” (Breedlove, 2005). In June 2010, Melinda Gates, of the Gates Foundation spoke at a Women Deliver Conference. Gates discussed a world where “women are given the knowledge to make better decisions about their health and their children’s health.” We can give birthing women the facts about support in labor, teach that our bodies are marvels and perfect for the job of birth, and that best evidence-care proves that to be so. The studies that refute interference with normal birth are mounting, and more and more the OB profession realizes, sometimes in a very self-congratulatory way, that things can and must change. (As example, see “Changes in Episiotomy Practice: Evidence-based Medicine in Action, Lapin & Gossett, 2010.)

We know that continuous labor support does make for better outcomes, although research-wise, the exact reason that happens is not established.  The Kayne study mentioned above says this: “Whether it is the role of the support person as comforter or protector that leads to better obstetric outcomes is still unanswered.” The most recent Cochrane review theorizes that the stresses of hospital birth are dis-empowering, raising stress levels that impede both the dynamic and subtle mechanisms of normal labor.  Research aside, we understand intuitively that continuous support in labor both protects and comforts; it acknowledges the vulnerability of a woman in labor and can provide, both through advocacy and unconditional acceptance of everything she does, an antidote to fear, and the path to a safe birth that will be remembered with joy.

References

1-Breedlove, G., Perceptions of Social Support from Pregnant and Parenting Teens Using Community-Based Doulas, J. Perinatal Educ 2005 Summer; 14(3): 15-22

2-Gates, Melinda. Full speech available at: http:/www.livestream.com/womendeliver/video?clipId=pla_7e848eb5-43eb-41e4-a5d3-e6de7cab31bc&utm­_source=1slibrary&utm_medium=ui-thumb.

3- Hodnett, E.D., Gales, S., Hofmeyr, G.J., Sakala, C., Weston, J. 2011, Continuous Support for Women during Childbirth, Cochrane Review

4-Kayne, M.A., Greulich, M.B., Albers, L. Doulas: An Alternative Yet Complementary Addition to Care During Childbirth, 2001, Clinical Obstetrics and Gynecology, 2001; .44(4):692-703

5-Doulas as Childbirth Paraprofessionals: Results from a National Survey, Lantz, P.M., Low L. K., Varkey, S., Watson R.L. Women’s Health Issues, 2005,15:109-116.

6-Lappen, J.R., Gossett, D.R., Changes in Episiotomy Practice: Evidence-based Medicine in Action, Expert Rev of Obstet Gynecol. 2010;5(3):301-309

7- Lothian, Devries: The Official Lamaze Guide (New York: Meadowbrook Press, Simon & Schuster Publising, 2005, 2010), Appendix C, p 261.

8- Sakala, C., Corry, M. 2008, Evidence-based Maternity Care: What it is and What it Can Achieve. (Milbank Report

Posted by:  Jackie Levine, LCCE,FACCE,CD, CLC

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