Science & Sensibility

by Christine H. Morton, PhD and Monica Basile, PhD, CPM, CD(DONA), CCE (BWI)

Last month there were great discussions after a study was published by the University of Minnesota, examining the potential cost savings to Medicaid if doulas worked with Medicaid clients, helping to reduce interventions and cesareans.  Today and next Tuesday, regular contributor, Christine Morton and her colleague Monica Basile, take a look at that study and another from Oregon, and share thoughtful insight about topics that might still need to be addressed if costs savings were to be effectively realized in a two part blog post. – Sharon Muza, Community Manager, Science & Sensibility

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How can doula supported births help reduce the cesarean rate and realize cost savings within Medicaid-funded births? Two studies published last month offer the opportunity to address this complex question.

We support the goal of increasing access to doula supported care to childbearing people of diverse racial/ethnic and class backgrounds, and we are pleased that discussions are taking place about how doulas may be able to help reduce racial disparities in maternal and infant health. We recognize that work toward these goals requires policy advocacy, which depends heavily on economic arguments for the benefits of doula care.

However, by limiting the discussion of benefits to the economic impacts of reduced cesareans, advocacy for Medicaid funding of doula supported births—without specifying the doula model of care and without according true value to the doula’s impact—may have unintended consequences for individual doulas, and the organizations that represent them.  One such consequence may be that the resulting system will continue to perpetuate a model of economic marginality and potential exploitation for the doulas who serve a low income population of childbearing people.

The AJPH study by Katy Kozhimannil and colleagues in Minnesota received a lot of media attention when it appeared last month, even live coverage in the Huffington Post.  This study compared 1,079 selected Medicaid doula patients in Minnesota to Medicaid patients nationwide for their total cesarean rates.  They found that doula clients of a community program in Minnesota had a rate of 22.3% while national Medicaid had 31.5%.  The authors reported three scenarios, all assuming that if states reduced cesarean rates, by offering doula services, there would be varying levels of cost savings, depending on the cesarean rate achieved, and by reimbursing doulas between $100-300 per birth.

In our view, the Minnesota study design raises several methodological questions, which are applicable to this study and to future research on doula-attended births. We outline those questions here, as well as raise several more substantive concerns about the implications of the study’s stated conclusions.

1. Why did the researchers not compare Minnesota Medicaid doula clients to Minnesota Medicaid women who gave birth?  Minnesota has a much lower rate of total cesarean that the US as a whole (27.4% during this time period), and this would have been a better matched comparison.  A better comparison would be doula attended births vs. non-doula attended births at the same facility.  It is not clear from the study whether the doula program whose data was utilized served women at one or multiple hospitals in Minneapolis. 
2. Why did the researchers not limit their investigation to primary cesareans?  Doulas typically support women in labor rather than women undergoing repeat cesareans.  The total cesarean rate includes repeat cesarean so it will be much higher than the primary cesarean rate, which is more applicable to doula clients.  Including total cesarean rates means that the researchers are comparing a limited universe (doula support of women in labor) to all births (thus including repeat and primary cesarean).   The data source for this study, (Nationwide Inpatient Sample), however, does not have this information.
3. Cesarean rates are very dependent on the parity distribution of the birthing population, so first time mothers need to be compared to first time mothers and multiparous women to multiparous women. This information is not available in the data source used by the researchers, but in future studies of this type, it is critical to verify that the proportion of each is the same in the intervention and control populations.
4. States are implementing a number of payment reform models to reduce cesareans among women covered by Medicaid, with limited success.  In part, that is because cesareans are influenced by a number of factors, with payment incentives only one.  (Many of these issues are covered in the CMQCC white paper on improvement opportunities to reduce cesareans, which argues that a multi-pronged strategy is necessary). 
5. Because hospital rates of cesarean have been shown to have high geographic variation in a number of studies (Baicker 2006; Main et al 2011; Caceres 2013; Kozhimannil 2013), it may be more feasible to have comparison groups of hospitals with similar primary cesarean rates.  Until we understand what accounts for variation in cesarean rates between institutions (unit culture; facility policies and protocols), it may be premature to assess the independent effect of labor support by a trained doula.

While doula support is associated with fewer cesareans across the board (Hodnett 2012), the methodological issues described above are likely to over estimate the benefits of doula-attended births in terms of reducing the cesarean rate for Medicaid covered births.  This, in turn, raises questions about the purported cost savings.  In the Minnesota study, the cost breakpoint is no more than $300 dollars for the doula per birth.  In most cities, doulas charge well above this amount for fee-for service care.

A cost-benefit analysis by Oregon Health & Science University researchers for the Oregon State Legislature was presented at the Society for Maternal Fetal Medicine in February 2013, which found that doula care in labor provides a cost benefit to payers only when doula costs are below $159.73 per case.  In that study, data sources are not entirely clear, but do seem to come from the OHSU facility where a hospital-based doula program is in place.  In that program, doulas are on call on weekends only and come to assist in a labor when requested by the woman during her prenatal care or when she arrives at the hospital.  A case-control study claiming the benefits of this doula model at OHSU was published as an abstract, and although it claims “women receiving doula care were statistically less likely to have an epidural during labor (p = 0.03), have an episiotomy (p = .03), or cesarean delivery (p = .006) and on average, doula attended women had a shorter hospital stay compared to the control group (p = .002),” nowhere does it show what the actual rates were.  This is important, because, they are likely to be relatively low overall, given that OSHU is a teaching hospital, with midwives and family practice physicians providing maternity care.

There are several types of doula models; not all have the same components.  The community-based doula model, as exemplified by the HealthConnectOne approach has a solid evidence base. This model employs doulas who are trusted community members, and provides extensive prenatal and postpartum support in addition to continuous labor support.  Doulas work collaboratively with community organizations, have extensive training in experiential learning and cultural sensitivity, and are paid a wage commensurate with their value and expertise, serving an important workforce development and grassroots empowerment function. Some so-called community doula programs do not incorporate all these components.

Hospital-based programs usually assign or utilize an on-call doula, who has not met the mother in advance and is not likely to follow up postpartum.  Some advocates of Medicaid doula programs utilize the community health worker (CHW) model, which seems to mirror the community-based doula (CBD) model but with important differences.  The American Public Health Association has defined CHWs as “frontline public health workers who are trusted members of and/or have an unusually close understanding of the community they serve.”  Yet, despite their widespread utilization in public health over the past several years, the conditions of their training, job opportunities, and even job description are idiosyncratic, and highly varied, and this “lack of CHW identity and standards of practice has led employers to contribute to the confusion about who CHWs are and what they do.” While the CHW and CBD models offer important job opportunities to members of under-resourced communities, their wages are often on the low side, with full time work paying $35,000 to $42,000 annually.  According to a health careers website, “CHWs often are hired to support a specific health initiative, which may depend on short-term funding sources. As a result, CHWs may have to move from job to job to obtain steady income.  This short-term categorical funding of health services is a challenge to the stability and sustainability of the CHW practice.”

In cost-benefit or cost effectiveness studies, it is critical to clearly specify the doula model of care on which the economic model is based.  It seems the doula model in the Minnesota study incorporates extensive pre and post partum contact and that there is an attempt to match doulas and clients in terms of race/ethnicity and language, but this is not always possible.   The study does not indicate what the doulas in the Minnesota program were paid, however, and that information was unavailable on their website.

Before we move to the topic of reimbursement, we want to note that the type of doula model is critical for assessing the benefits of doula-attended births.  The research clearly shows different outcomes for doulas who are affiliated with hospitals compared to those who work independently (Hodnett, 2012).  If a cost benefit model shows little gain in terms of outcomes, or yields a price point in the low hundreds of dollars, it may be that findings are affected by the assumptions embedded in the calculations.

More fundamentally, however, we argue that doula benefits cannot be captured solely through an economic model.  Neither should doulas be promoted as a primary means to reduce cesarean rates.  Both strategies (economic benefits and cesarean reduction) for promoting doulas have significant barrier.  In part two of this topic, running on Tuesday, April 2nd,  we discuss our concerns about reimbursement and program sustainability alongside a caution against relying too heavily on arguments that position the doula as primarily a money saver and cesarean reducer.

References

Baicker, K, Kasey S. Buckles, and Amitabh Chandra. Geographic Variation In The Appropriate Use Of Cesarean Delivery: Do higher usage rates reflect medically inappropriate use of this procedure? Health Affairs 25 (2006): w355–w367; doi: 10.1377/hlthaff.25.w355

Caceres, Isabel A., Mariana Arcaya, et al., Hospital Differences in Cesarean Deliveries in Massachusetts (US) 2004–2006: The Case against Case-Mix Artifact, PLoS ONE 8(3): e57817. doi:10.1371/journal.pone.0057817

Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews, 2012, Issue 10. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub4.

Kozhimannil, Katy Backes, Michael R. Law, and Beth A. Virnig. Cesarean Delivery Rates Vary Tenfold Among US Hospitals; Reducing Variation May Address Quality And Cost Issues, Health Affairs 32, NO. 3 (2013): 527–535; doi: 10.1377/hlthaff.2012.1030

Main EK, Morton CH, Hopkins D, Giuliani G, Melsop K and Gould JB. 2011.  Cesarean Deliveries, Outcomes, and Opportunities for Change in California: Toward a Public Agenda for Maternity Care Safety and Quality.  Palo Alto, CA: CMQCC.  (Available at http://www.cmqcc.org/white_paper)

About the authors

 

Monica Basile has been an active birth doula, childbirth educator, and midwifery advocate for 17 years, and holds a PhD in Gender, Women’s and Sexuality Studies. Her 2012 doctoral dissertation, Reproductive Justice and Childbirth Reform: Doulas as Agents of Social Change, is an examination of emerging trends in doula care through the lens of intersectional feminist theory and the reproductive justice movement.

 

Regular contributor Christine H. Morton, PhD, is a sociologist whose research on doulas is the topic of her forthcoming book, with Elayne Clift, Birth Ambassadors: Doulas and the Re-emergence of Woman-Supported Birth, which will be published by Praeclarus Press in Fall 2013. For more on Christine, please see Science & Sensibility’s Contributor page.

Christine Morton Cesarean Birth, Doula Care, Guest Posts, Healthy Birth Practices, Healthy Care Practices, Maternity Care, Research, Uncategorized cesareans, Christine Morton PhD, doulas, Medicaid and maternity care, Monica Basile, research

 

Join us for a Webinar on Thursday, February 28,  from 12 p.m. to 1 p.m. EST.  

Lamaze International and OB Consult are collaborating on a joint education initiative to provide evidence-based and complimentary educational services to OB nursing staff and physicians on their role in supporting patient childbirth education and participation, resulting in enhanced physician-patient relationships, engaged mothers, and healthier babies.  This Webcast officially launches this new collaborative initiative.

Childbirth preparation has been an integral part of the birth experience for centuries, in the beginning as experiential learning when births occurred in the home and then in the 50s and 60s as part of a formal curriculum in physician offices, hospitals and the community.

Travel with us through time to see how the trends in childbirth and childbirth education can impact the care that pregnant women and their families experience in the 21st century.

• Is childbirth education a passing fancy or an integral part of the childbirth experience?
• How can physicians, nurse midwives and nurses work together to create a safe and satisfying birth experience for all involved?

Learn about evidence-based strategies that you can put into place now and in the future to educate all stakeholders in the experience of birth.

This presentation is open to all OB department staff, including OB-Gyns, OB department managers, OB nurses, lactation consultants, educators, doulas and the rest of the OB team.  This includes YOU!

This presentation features our own Michele Ondeck, RN, MEd, IBCLC, LCCE, FACCE,  Lamaze International President-Elect and Margaret “Peggy” M. DeZinno, BS, RN, LCCE, an OB-Gyn risk management specialist.

This is a great opportunity to learn more about the Lamaze International and OB Consult cooperative venture, and clarify the importance of your role in supporting families and babies as part of the OB team.

Find more information on the Lamaze International Webinar page. Register now by following this link.

For more info, questions about registration or webinar content, please contact OB Consult at 717.399.6658 or ceb@ob-consult.com

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Space is limited.
Reserve your Webinar seat now at:
https://www1.gotomeeting.com/register/245111544

 

Childbirth preparation has been an integral part of the birth experience for centuries, in the beginning as experiential learning when births occurred in the home and then in the 50s and 60s as part of a formal curriculum in physician offices, hospitals and the community. Travel with us through time to see how the trends in childbirth and childbirth education can impact the care that pregnant women and their families experience in the 21st century. •     Is childbirth education a passing fancy or an integral part of the childbirth experience? •     How can physicians, nurse midwives and nurses work together to create a safe and satisfying birth experience for all involved? Learn about evidence-based strategies that you can put into place now and in the future to educate all stakeholders in the experience of birth.

 

Title:

Childbirth Education – A Collaborative Role for Nurses and Doctors

Date:

Thursday, February 28, 2013

Time:

12:00 PM – 1:00 PM EST

Sharon Muza Babies, Childbirth Education, Continuing Education, Evidence Based Medicine, Lamaze International, Maternal Quality Improvement, Webinars Continuing Education, doulas, L&D Nurses, lactation consultants, Lamaze International, Lamaze webinars, Margaret DeZinno, maternity care continuing education, Michele Ondeck, midwives, OB Consult, Sharon Muza

 

I’d like to draw your attention to a very important study that is currently looking for participants – The Maternity Support Survey. This comprehensive study is the first to compare doulas, childbirth educators, and labor and delivery nurses, working in the United States and Canada, in terms of their approach to maternal support and care. The survey explores these individuals’ knowledge and attitudes toward current childbirth practices, technologies and support.  Now is your opportunity to share how you view your responsibilities.  This research team wants to hear from you!

The team behind the research has been working for over two years via conference calls to develop the survey and methodology.   The research team consists of Louise M. Roth, PhD, (Principal Investigator), Christine Morton, PhD (Co-PI and regular contributor to this blog), Marla Marek, RNC, BSN, MSN, PhD(c), Megan Henley, Nicole Heidbreder BSN, MA, Miriam Sessions, Jennifer Torres, and Katie Pine, PhD.  They are sociologists and nurses, working in California, Arizona, Washington DC, Michigan, and Wyoming.  To raise funds for the project, they launched an Indiegogo campaign and have been featured on the Every Mother Counts blog.  The Maternity Support Survey has been approved by the Institutional Review Board of the University of Arizona, and Louise M. Roth, PhD, is the Principal Investigator of the study.

I’m sure the readers of this blog are aware that research has shown that support during labor and delivery has a significant impact on method of delivery, maternal and neonatal morbidity, and rates of postpartum depression. Yet existing research in maternity care has largely focused on how mothers and families view their care or on the perspectives of midwives and obstetricians, with less attention to the views of individuals who provide support to women during pregnancy and birth. The Maternity Support Survey is addressing this need.

Topics that the survey investigates include: whether doulas and childbirth educators view their maternity support work as a career, how doulas and childbirth educators establish their expertise, how technology affects workload among labor and delivery nurses, how maternity support workers are affected by managed care and litigation concerns, and emotional burnout among maternity support workers.

The Maternity Support Survey has partnered with Lamaze International and the following organizations in the recruitment of participants: Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN); Birthing from Within; International Childbirth Education Association (ICEA); BirthWorks; DONA International; toLABOR (formerly ALACE); and CAPPACanada.  These organizations felt that this research was important enough to reach out to their collective members with a request for participation.

The survey launched in November 2012 – the organizations above sent emails to their members, along with monthly reminders.  By early mid January 2013, the survey had logged 1500 responses, with relatively equal numbers of each group responding.  Then, the research team decided to extend the reach of the survey to those doulas, CBEs and L&D nurses BEYOND the membership organizations.  A viral social media blitz ensued, with positive results.  Within a week, the survey logged an additional 600 responses.  As of January 21, 2013, the survey has been completed by just over 2100 respondents.  Doulas now comprise about 44%, with L&D nurses at 35% and CBEs at 33% of the total respondents.  The survey will be open through mid-March, so there is still time to share widely among your networks.  Data cleaning will happen in April, and analysis will begin in May 2013.  The researchers plan to disseminate their findings at conferences and publish in journals of interest to these occupational groups as well as in sociology and other fields.

Those of you who are members of these organizations may have already received an email with a link to the survey (and hopefully have already completed it). However, if you are not a member of one of these national organizations OR have NOT received an email from your organization inviting you to take the survey, here’s how you can share your views:

The survey is available online for US residents here.

The survey is available online for Canadian residents here.

The survey takes approximately 30 minutes to complete, and participation is entirely voluntary. The research team will NOT have any way of personally identifying you or your responses, and will not contact you for any purposes unrelated to this survey or give your information to any commercial organizations. For questions or feedback, please contact Louise M. Roth, PhD.

 

Sharon Muza Childbirth Education, Lamaze International, Maternal Quality Improvement, Maternity Care, Patient Advocacy, Research, Research Opportunities Childbirth Education, childbirth educators, doulas, L&D Nurses, Lamaze International Christine Morgan, maternity care, Maternity Support Survey, research

Holidays are a time when many of us gather with with family and friends, when hearts are open, tables are full, spirits light and oxytocin flows just from being with those we care about and sharing meals and good times. For some families, babies arrive on the holiday to make the day even more special and significant then other years. For health care providers, doctors, nurses, midwives, doulas, birth photographers, lactation consultants and those that work with birthing families, holidays are often times spent away from their own friends and families so they can help women become mothers and see the birth of a family.

I have a clear recollection of being pregnant with my second daughter through the holidays of 2000. Grumpy, crabby, “done” with being pregnant, and very mad that everyone else seemed to be so festive and happy. Hard to make plans for holiday gatherings and meals, unwilling to have people over and not wanting to go elsewhere, I complained my way through each day, surprised like any other fully pregnant 40 weeker, that I would wake up each morning in my bed, “still pregnant.” I agreed to join friends for our traditional sushi rolling party that we did every New Year’s Eve, and pregnant or not, I was going to be rolling and eating sushi. Alas, baby felt like joining the party, and I went into labor New Year’s Eve. A slow labor ramp up seems to be the way my babies come, and I mildly contracted through the night, all New Year’s Day and into that night. As was the case, I seem to go from early labor to transition rather quickly and soon was pushing a baby out into the world in the pre-dawn hours on January 2nd. 01/02/01. Missing 01/01/01 by just a few hours. Missing the tax break and a New Year’s Eve baby by a day. Regardless, a memorable New Year nonetheless for myself and my family.

I sit now waiting for the call to join a client as her birth doula, as other women, clients of mine, tick the hours past the holiday celebrations, very pregnant and wondering if they too, will have a holiday baby.

As a doula for over 10 years, I have attended births on every holiday, my birthday, and my children’s birthdays, as those babies come when they want to, regardless of the plans of those of us on the outside!

I thought I would check in with those women who have given birth on a holiday like July 4th, Valentine’s Day, Christmas, New Year’s, Halloween and others to find out what their experience was like. And also ask those who themselves were born on a holiday, how has it been forever having their birthday associated with a holiday well known by many here in the US.

“I birthed on a holiday!”

Most of the women I spoke to who gave birth on a holiday had gone into labor spontaneously. Several of them had a long labor, for several days, with the baby making their appearance on the holiday. I wondered if they felt that their birth team minded not being with their family on the holiday. Everyone reported that, regardless of home birth or hospital birth, the birth team seemed very present, happy to be there and upbeat about welcoming the new baby. A few hospital birth mothers remarked at how empty and quiet the hospitals were during their births. Discharge seemed to take a bit longer and it was sometimes harder to be seen by a lactation consultant or other specialist. Some babies born on Christmas were given a green and white striped hat instead of the “normal” newborn baby hat after birth.

Many women talk about celebrating their child’s birthday on the original holiday date when the child is young, but as they get older, they have moved the celebration to a day that is not the holiday, so that friends and family are more available to join in the celebration. They shared that others seem “dismayed” that they gave birth on a holiday, expressed regrets for the child’s birth date, as if it was a bad thing.

I recall being at a birth on July 4th, and the baby was born about 30 minutes before the fireworks over the city were to happen.  The midwife and nurses turned off all the lights and we swung the mother’s bed completely toward the wall of windows, and the new family, and staff and I all watched the big fireworks show in silence, baby snuggled at mother’s breast.  I whispered in the baby’s ear later on, “Remember, these fireworks will always be to celebrate *your* special day!”

All the women I spoke to, who birthed on a holiday, made sure to comment and share that they felt it was important to have the baby pick its birth date, and be born when it is ready, even if that is a holiday. They all recognized what Lamaze speaks to when we share information in our Healthy Birth Practice, Let Labor Begin On Its Own.

The women all stated that they wanted to be sure that their child, born on a holiday, would always feel special and have celebrated, and not have their child’s birthday get lost in the shuffle of holiday celebrations.

“I was born on a holiday!”

I spoke with women who themselves were born on a holiday and they shared what it was like to have to share their birthday with a holiday that everyone was celebrating.  The folks who were born on Christmas or New Year’s shared that they frequently felt like their birthday got “overlooked” or “short shrift” in the celebrations of the season.  As a child, they often had to express their frustrations and share that they  needed their families to make their birthdays special, “If I was born in August, would you wrap my birthday gifts in Christmas wrapping?” said one woman.  Gifts often said “Merry Christmas and Happy Birthday.” One woman, born on New Year’s Day remarked; “At least I wasn’t born on Christmas!”

Many women who are born on other holidays, like Halloween or 4th of July, share that it was great fun growing up with that birthday date, and continues to be fun into adulthood.  One woman shared that being born on April Fool’s Day was not fun, and she got pranked a lot with empty boxes wrapped as presents and other jokes.  Not something she has enjoyed, and she shared; “I felt like my birthday was always a joke!”

“I worked with birthing women on a holiday!”

I also spoke with health care providers, who shared that they enjoyed working on holidays, that facilities were often quiet, and low key, and the birthing families that they work with seemed extra appreciative of their support on the holiday.  They often wear a little something special to make things more festive, a Santa hat, or Halloween headband or an American flag on July 4th.  Sometimes, hospitals put something special on the meal tray, a flower or decorated cookie.  They are glad to be helping in any way they can.

Conclusion

I think that family and friends, and even the public makes a lot of comments to pregnant women who may find themselves likely birthing on a holiday, adding an extra layer of stress for these women, to what can already be a time period raw with emotion at the end of pregnancy. I am glad that these women are treated well by care providers.  None of the women who responded to my small, unscientific survey said that they felt pressure to induce to avoid a holiday birth date.

I think that as educators, we can stress that babies come when they come, and recognize the additional pressures that women may feel to birth or avoid birthing on a holiday date. We can provide tips on coping with holiday celebrations and plans when “very pregnant” and honor the emotions that some of the women may be experiencing.  Reassuring women that their babies know when to be born and helping them to prepare for however things unfold is a gift we can give to our students and clients.

Have you birthed on a holiday?  Were you born on a holiday?  Do you support birthing women and frequently work on a holiday.  Please share your experiences with all the readers in the comments and let us know what your experience was.  Is anyone waiting on a baby now? Do you expect to get called to a birth? Are you working in a hospital?  On call? Finally, a huge thank you to all the professionals who give up their holidays to support the new babies coming into the world.

 

Sharon Muza Babies, Childbirth Education, Healthy Birth Practices, Newborns, Science & Sensibility Childbirth Education, doulas, Healthy Birth Practices, Holidays, L&D Nurses, lactation consultants, midwives, newborns, obstetricians, Sharon Muza

I just returned from Cancun, Mexico, where I was attending DONA International’s 18th Annual Conference and helping DONA to celebrate their 20th birthday.  I was lucky enough to be selected to present a concurrent session on “The Paperless Doula- Virtual Paperwork Tips and Tricks” and attend many fabulous sessions with international speakers during the four day conference.

During my time at the conference, I was struck by how many familiar Lamaze faces and names I was meeting.  I caught up with Ann Grauer, DONA International Director of Education, (and LCCE) and asked her exactly how many Lamaze Certified Childbirth Educators were registered for the 2012 conference.  I was surprised to learn that 37 LCCEs were in attendance at this year’s DONA conference!  I was so proud to see that Lamaze International was a major sponsor of the 2012 DONA Conference and our presence was everywhere.  Lamaze International members and certified educators were Keynote Speakers, Concurrent Session Speakers, serving on the board of directors of DONA and peppered throughout the audience. LCCEs and trainers, Elena Carrillo and Guadalupe Trueba taught a Lamaze workshop before the conference and were the recipients of the Penny Simkin Award this year.

In talking to Ann Grauer, former DONA President, she informed me that when she served in the president’s position in 2005, she required the entire DONA board to take a Lamaze workshop, as she felt that the values and principles of the two organizations were so similar.  Being a member and certified by both DONA and Lamaze, I have long been aware of how like minded and compatible both organizations are, but was struck with how closely both these groups support each other, share membership, and have the core principles of supporting normal birth, evidenced based medicine and informed choice for birthing women and their families at their core.

In Cancun, I met up with Lamaze International’s President-Elect, Tara Owens Shuler, MEd, CD(DONA), LCCE, FACCE, for a few minutes, during a break in the conference action, to talk to her about DONA and Lamaze International’s unique relationship.  Tara commented that there is a “natural pipeline between the doula and the childbirth educator” and that DONA and Lamaze have had a strong unity and association for a long time.  Tara shared how she believes that both organizations are leading the way in working for women and  share the common bond of being long time advocates for normal birth.

Tara noted how both DONA and Lamaze are expanding their reach internationally, with both organizations holding workshops and trainings around the globe and making a concerted effort to develop membership beyond North America.  Our groups face the same challenges.

Tara shared how this was her first DONA International conference and she was delighted to participate and glad that Lamaze International could have such a strong presence in sponsorship and in participation by members.  Tara said that she had a new vision on how strong and committed doulas are and was especially moved by the singing of DONA Nobis Pacem at the closing ceremony of the conference.  Tara was struck by how much DONA International had accomplished in the 20 years since it was formed by Penny Simkin, Annie Kennedy, Phyllis and Marshall Klaus and John Kennell.

Tara stated how she hoped that both organizations can continue to collaborate and share resources, as they work to celebrate birth and support women during the childbearing year.  I was glad that Tara, a DONA certified doula herself, could come and join in the conference and represent Lamaze in such a professional and graceful manner.

I look forward to learning more about how Lamaze International and DONA International can work together to help promote normal birth, offer support for women during their pregnancies, labors, births and postpartum periods, while furthering the practices that are evidenced based and produce positive outcomes for mothers and babies.

If you are an LCCE and attended the DONA International Conference, please let us know your thoughts and experiences while in Cancun.  If you are not an LCCE, did attending the conference encourage you to pursue training with Lamaze?  I would love to hear your experiences.  Please comment here.

 

 

 

Sharon Muza Childbirth Education, Continuing Education, Doula Care, Evidence Based Medicine, Lamaze Method, Push for Your Baby, Science & Sensibility, Social Media Childbirth Education, conferences, DONA, doulas, Lamaze International, Sharon Muza, Tara Owens Shuler