…is up! Go check it out at Giving Birth with Confidence. What a PHENOMENAL collection of contributions about the moments, hours, and days after birth. Each of our Blog Carnivals has vastly surpassed my own expectations. I hope you’ll agree.
[Editor's note: This is a guest post from former Lamaze International President, Jeannette Crenshaw. When Jeannette told me about the video she reviews in this post, I knew I wanted to highlight it as part of the Sixth Healthy Birth Blog Carnival.
I recall one birth I attended as a midwife, I had to negotiate with the nurse about how long we would "let" the mother and baby remain in skin-to-skin contact after birth. Her reason for wanting to disrupt skin-to-skin time? "I have to put the baby in the computer." Her job (completing birth documentation) was interfering with her job (safeguarding the health and wellbeing of the mother and baby).
Hospital routines are the #1 reason mothers and babies are denied skin-to-skin contact after birth. Changing this harmful practice is possible, but it takes a commitment to quality and systems improvement. Now that the Joint Commission is measuring hospital perinatal quality by the proportion of babies exclusively breastfed at discharge, hospitals need concrete tools to retrain staff and change delivery room culture. Hospitals: it seems like this video may be $39.00 well spent. - AMR]
Skin to Skin in the First Hour After Birth:
Practical Advice for Staff After Vaginal and Cesarean Birth (DVD)
Executive producer and videographer: Kajsa Brimdyr, PhD, CLC; executive and content producers: Kristin Svensson, RN, PhD (cand.) and Ann-Marie Widström, PhD, RN, MTD.
$39.00 at Healthy Children
A new DVD from Healthy Children Project should be mandatory viewing for every labor and delivery nurse and birth attendant. It will help maternity health professionals in hospital settings to implement the best practice of uninterrupted skin to skin care beginning immediately after birth until after the first feeding. This is a “how to” DVD, with the practical advice health professionals need to provide clinical care to mothers and babies who are skin to skin immediately after a vaginal or cesarean birth.
The 40 minute DVD, set to original music by J. Hagenbuckle, has 3 content sections, and a section with a complete list of references. The first section describes the short and long term benefits of skin to skin care for newborns and mothers. It shows the 9 stages healthy newborns experience while skin to skin during the first hour after birth—from the birth cry (stage 1), through suckling (stage 8), and sleep (stage 9). The narrator emphasizes the individual way each baby moves through the 9 stages.
The second section shows how to provide care for mothers and babies while they are skin to skin, after a vaginal, and the third, after a cesarean birth. Both sections begin with health professionals teaching pregnant women about immediate skin to skin care prenatally, and on admission to the hospital—which “sets the stage” for immediate skin to skin contact as a normal part of the birth process. After the vaginal birth, the clinician immediately places the baby on mom’s abdomen. After the cesarean birth, the nurse immediately places the baby on mom’s chest, above the sterile field and drapes, as the doctor continues the surgery and the anesthesiologist monitors the mother. The baby’s father is at mom’s side in both segments. Nurses remove birth fluids as they dry the baby—delicately addressing the common concern that babies should first be “cleaned up” at a warmer. Nurses remove wet blankets, place the baby skin to skin, and cover mom and her baby with warmed blankets. Both sections show competent nurses assessing the newborn, providing care, and supporting the mother and baby as the baby moves through the 9 stages of skin to skin.
I strongly recommend this DVD (only $39.00) for staff in any maternity setting. Childbirth educators will find the first section of the DVD a great addition to their prenatal childbirth and breastfeeding classes (although Breastfeeding—A Baby’s Choice, 2007, may be a better choice). Staff who are working to help their hospitals achieve Baby-Friendly designation will find this DVD useful for training. The narrator uses, for the most part, simple and non-clinical language and the video of mothers and babies will quickly engage the viewer. The DVD’s producers met their objective: “to assist staff in providing behaviorally appropriate, individualized, baby adapted care for the full term newborn using the best practice of skin to skin contact in the first hour after birth”.
Reference:
Healthy Children Project. (Producer). (2007). Breastfeeding—A Baby’s Choice [DVD]. Available from http://www.healthychildren.cc/
Jeannette Crenshaw, MSN, RN, NEA-BC, IBCLC, LCCE, FACCE is a member of the graduate faculty at the University of Texas at Arlington College of Nursing and a family educator at Texas Health Presbyterian Hospital Dallas. She represents Lamaze on the United States Breastfeeding Committee (USBC) and coordinates the Lamaze Breastfeeding Support Specialist Program. She has published articles and presented nationally and internationally on a variety of topics, including evidence based maternity care.
I have felt a little bit like a slacker blogger lately, but it’s not for lack of thinking and writing about birth. I just wrapped up an article called Social Media, Power, and the Future of VBAC with Hilary Gerber from Mom’s Tinfoil Hat and Desirre Andrews from Preparing for Birth which we submitted to the 50th anniversary “Looking Back – Looking Forward” special issue of Lamaze’s Journal of Perinatal Education. I’ve also been working with Kristen Oganowski from Birthing Beautiful Ideas to coordinate the development of an NIH VBAC Statement Primer for consumers. We have a bunch of brilliant contributors on board and will be launching the primer later this month at Lamaze’s new (very cool!) social networking site for women, Giving Birth with Confidence.
Now the big looming work comes in the form of conference season. And I want you (yes YOU) to help me. I have a love-hate relationship with conferences. Mostly love. I love how much sharing, connecting, and learning happens. I love finding out what old friends and colleagues are up to and meeting the people doing the most interesting, innovative, and important work in the field. But attending (and especially speaking at) a conference is a lot of work, and often disrupts progress in my other (equally if not more important) work. Also, I hate that conferences take me away from my family.
So…I want to make the most of the opportunities these conferences offer. I want to maximize the amount of sharing, connecting, and learning we – collectively – do. And I want to leave these conferences not with tons of new projects and commitments for myself, but with tons of new opportunities for the broader maternity care community (that means YOU) to drive meaningful improvements for women, infants, and families.
Here’s some more about the conferences I’m attending, and how YOU can be part of them.
On June 7 I’ll be at Health 2.0 Goes to Washington.
Um, have I mentioned lately that I think social media is going to transform maternity care? Well I developed this delirious optimism by hanging around (online) with the Participatory Medicine crowd. I get to actually meet most of them next week!
I first caught on to the Participatory Medicine train when I read a Grand Rounds blog carnival on the theme of “Meaningful Use” almost exactly a year ago. “Meaningful Use” is government speak for the goal of implementing electronic health records (with piles and piles of stimulus money) in a manner that actually improves care. The Participatory Medicine folks are front and center in the conversation, pushing for patient-access to be the defining characteristic of meaningful. It’s all about liberating the mounds of data that will exist in electronic health records and letting innovators, policy-makers, scientists, and – most importantly – patients themselves use that data to improve health.
I have 10 minutes to speak but a whole day to connect and learn. Here are my questions for you to help me make the most of this opportunity:
The following week (June 12-16), I’ll be at the American College of Nurse-Midwives Annual Meeting.
I’m only attending ACNM for one day, but traveling with my family for my kids’ first-ever trip to the nation’s capitol. I’m giving two educational sessions that couldn’t be more different from one another. First, I’m presenting a talk called, “How Not to Get Duped by Obstetric Research” about the importance of thinking critically about evidence, and how honing critical analysis skills can can help midwives practice and advocate for safe and effective care. The other talk is a panel discussion with Amie Newman from RH Reality Check and Mary Murry, CNM, from The Mayo Clinic “Pregnancy Week by Week Blog,” moderated by Melissa Garvey from ACNM’s own Midwife Connection Blog. We’ll be talking about why more midwives should be blogging and how they can get started. We recorded a really lively discussion about these issues on The Feminist Breeder & Friends Radio Show on International Day of the Midwife – a preview of our ACNM panel – which you can listen to here:
My questions for YOU:
Lastly but Oh-So-Not-Leastly, I’ll be attending the Normal Labour and Birth 5th International Research Conference in July.
I’m not speaking at this conference. I’m going for the sole purpose of blogging it! I wrote a proposal to the conference organizers suggesting that they let me attend and help disseminate the proceedings. They agreed! I think this is a huge opportunity to learn from the people doing the research about how to optimize the health and safety of healthy women and their babies around the time of birth. We’ll also hear from leaders who are creating and maintaining integrated, midwife-led primary maternity care systems, the gold standard for achieving “woman-centered, safe, effective, timely, efficient, and equitable” care.
What happened when bloggers and other connected consumers attended the NIH Consensus Development Conference on VBAC was astounding and continues to deliver. Since that experience, I’m addicted to putting scientific findings in the hands of engaged, connected consumers, because, as Kay Dickerson from the Cochrane Collaboration says, “We’ll only get evidence-based healthcare in this country through consumer activism.” Today activists have more access than ever before to information and are getting increasingly social media savvy. There’s no telling what we can do if we put our innovative, passionate minds to it and work collaboratively.
So here’s what I want to know from YOU:
Finally, any readers who are planning to attend any of these conferences – I invite you to submit a guest post. I’d love to share multiple perspectives (not to mention the tremendous work of blogging all of these meetings!) Just email me at amyromano [at] Lamaze [dot] org.
Keeping birth healthy and safe doesn’t end when the baby is out. Skin-to-skin contact, the beginnings of emotional attachment, the mother’s physical recovery, and the initiation of breastfeeding are the continuum of biological processes that began in pregnancy and labor. We’ve reached number six in our six-part series of Blog Carnivals. And this one is about keeping moms and babies together after birth.
That’s right – this is the last Healthy Birth Blog Carnival! The Carnivals, to me, represent the huge amount of information, support, and woman-to-woman collaboration the internet now offers to support safe and healthy birth. I’ve loved reading all of your stories, hearing diverse perspectives, and working together to generate a new understanding of the type of care that moms and babies deserve. I know I am in for some delightful and insightful reading – and some heartbreaking stories, too.
You can submit anything that relates to the care and support of mothers and babies after birth. Here are some resources from Lamaze International to get you started:
Participation in the Healthy Birth Blog Carnival is easy:
1. If you are a blogger, write a blog post on the Carnival theme. Post it on your blog by Friday, June 11. Make sure the post links back to this blog post, to the Healthy Birth Practice Paper, or to the video above. You may also submit a previously written post, as long as the information is still current.
2. Send an email with a link to your post to amyromano [at] lamaze dot org.
3. If you do not have a blog but would like to participate, you may submit a guest post for consideration by emailing it to me.
4. I will compile and post the Blog Carnival at Lamaze’s brand new web community for women: Giving Birth with Confidence.
I kicked off this blog carnival with a post titled, “Six Reasons I *Heart* Qualitative Research.” I had been wanting to write a post about qualitative research for a while, and the topic of the second stage of labor was the perfect opportunity, since there’s so much great qualitative research on second stage.
After collecting the posts for this carnival, I have discovered why. Women want to tell their stories about pushing their babies out. With only a couple exceptions, everyone who contributed to this blog carnival wrote about their own personal experiences.
Just like good qualitative research, the stories show what spontaneous, upright pushing looks, feels, and sounds like.
Contrast these with the stories that document the opposite: our cultural norm of rushed and managed birth, and the emotional and physical toll this approach can take.
Women who prepared carefully for birth were not necessarily immune to repression and coercion in second stage.
On the other hand, several bloggers’ stories show that it is possible, healthy, and feels amazing to push a baby out with one’s own immense power in all sorts of unexpected circumstances.
But we know that these stories are not the norm, at least in U.S. hospitals, where more than half of women with vaginal births give birth on their backs and 4 out of 5 are told how and when to push, according to the 2006 Listening to Mothers II Survey. Not surprisingly, many of the stories women shared were of births that took place at home, where women can more easily follow their own instincts to birth their babies, and are usually attended by midwives and labor companions who encourage and support those instincts.
The stories bloggers shared for this carnival are phenomenal and important. They call into question our cultural norms of what is safe, healthy, and appropriate care. Just as Robin at The Birth Activist learned in her childbirth class to reject the dominant cultural image of laboring woman as stranded beetle and Michelle at The Parent Vortex likewise began to question cultural ideals of men telling women how to give birth after reading Janet Balaskas’ book, Active Birth, perhaps the posts in this carnival will be the spark the next woman needs to question unhealthy, unsafe obstetric routines.
To me, the posts in this collection suggest that what happens during the second stage of labor and how well the women is cared for may be the most important factor in how she sees herself and interprets her experience after giving birth. Not surprisingly, the care and support that helped women feel triumphant and strong are also supported by evidence of optimal safety. But reading through these posts, I’m also struck at how difficult it is to foresee the roadblocks to safe and healthy second stage care, and give women the tools to navigate around them. Having made her choice to have a hospital birth with a group of doctors she likes, pregnant blogger Jenn from Baby Makin’ Machine is sick of people telling her how to have her baby. Jenn has discovered what almost every mom has discovered before her: everyone wants to tell you what to do and how to do it, whether or not you ask for their advice, and it doesn’t stop once the baby is born. The best way to find a path through it all and parent with confidence? Follow your instincts, be patient with yourself, be assertive when something seems unsafe or uncomfortable (even if everyone else seems to be going along with it), and fall back on common sense. It’s good advice for second stage and for parenting.
