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Lessons from a Snow Field

January 23rd, 2014 by avatar

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

source: flic

source: flic

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

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

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

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

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

source: flickr

source: flickr

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

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

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

About Kimmelin Hull

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

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

“Should We Private Bank Our Baby’s Cord Blood?” Information That Can Help You Answer That Question

September 21st, 2012 by avatar

www.flickr.com/photos/lovemybunnies/4740682244/

I was recently asked my thoughts on private cord blood banking by a couple expecting their first child.  This was something that they were considering and wanted to know what information was out there.  I had read various articles and commentaries on private cord blood banking in recent years, but I viewed this as an opportunity to refresh my knowledge before I provided an answer to them.  I wanted to share this information with Science & Sensibility readers, so that you may use it with your classes, clients and patients as well, if you wish.

Kimmelin Hull wrote a very comprehensive post on Science and Sensibility in April, 2011, discussing “Should we, or should we not retrieve Umbilical Cord blood at all?” along with providing information on delayed cord clamping current research, and referring readers to a fantastic Journal of Perinatal Education article, Umbilical Cord Blood: Information for Childbirth Educators, written by Renece Waller-Wise, MSN, CNS, CLC, CNL, LCCE.  Kimmelin Hull’s post and Renece Waller-Wise’s JPE article were great places for me to start my exploration to be able to answer this couple.

Today’s post is not about the benefits and/or risks of delayed cord clamping.  Information on that topic has been provided previously on this site.  What I was really looking for was more information on the likelihood that private banked cord blood might be used for that child or other relatives in the future.

Research indicates that pregnant women frequently do not have adequate information to make an informed decision about cord blood banking. (Fox, et al, 2007).   Additionally, the information sources for childbirth birth educators are frequently the private blood banks or their designated representatives, adding in the potential for bias. (Cord Blood Registry, 2009; Wolf, 1998, 1999) Interestingly, in the state of Washington, where I live, the state requires practitioners to provide information on cord blood donation and banking. (but not on delayed clamping.)

Revised Code of Washington (RCW) 70.54.220  All persons licensed or certified by the state of Washington to provide prenatal care or to practice medicine shall provide information to all pregnant women in their care regarding:

(1) The use and availability of prenatal tests; and

(2) Using objective and standardized information: (a) The differences between and potential benefits and risks involved in public and private cord blood banking that is sufficient to allow a pregnant woman to make an informed decision before her third trimester of pregnancy on whether to participate in a private or public cord blood banking program; and (b) the opportunity to donate, to a public cord blood bank, blood and tissue extracted from the placenta and umbilical cord following delivery of a newborn child.

Nationwide, 26 states have legislation on providing cord blood information. This legislation is intended to guide health care providers and inform parents about their options concerning donation and banking.  You can access this information on a state by state basis here. In Washington, exactly what information should be provided is not spelled out.

Stem cells are available from a variety of sources, but umbilical cord stem cells are the easiest to collect, collection is painless, and according to studies can be done before or after the placenta is delivered. (Gonzalez-Ryan, VanSyckle, Coyne, & Glover, 2000; Percer, 2009). The stem cells are quickly available to be used. But, according to one study, approximately 50% of all cord blood collection samples contain an insufficient volume of blood.  (Drew, 2005).

Private cord blood banking is often marketed as “biological insurance” for potential problems with that child in the future. “Autologous transplant” is where the cord blood is given back to the child it was taken from.  The chance that a child will need its own cord blood is extremely small; a 1:400 to a 1:200,000 chance over the child’s lifetime (Sullivan, 2008). In the case of some illnesses, it would be unwise to transfer the same cord blood cells as they are considered “contaminated” with the very disease that is hoping to be cured.

There is not a lot of research on the period of time that a collected cord blood sample would be viable after storage, and no research on viability over the course of the average human lifespan.

Private cord blood banking is not without significant expense and cost.  Collection and initial processing can run approximately $3000, and then there is an annual fee that can run several hundred dollars for storage each year after that.

Private cord banking services are not regulated, either on the federal level or by the state, so without oversight, regulations and a quality assurance program managed by a third party, consumers may find themselves dealing with programs that could not be financially viable over the long term or may not be handling or storing stem cell products appropriately.

What do various organizations say about private cord blood banking?

 American Congress of Obstetricians and Gynecologists (ACOG)

ACOG has a statement on Umbilical Cord Blood Banking and in their recommendations and conclusions they state:

  • If a patient requests information on umbilical cord banking, balanced and accurate information regarding the advantages and disadvantages of public versus private umbilical cord blood banking should be provided. The remote chance of an autologous unit being used for a child or a family member (approximately 1 in 2,700 individuals) should be disclosed.
  • Discussion may include information regarding maternal infectious disease and genetic testing, the ultimate outcome of use of poor quality units of umbilical cord blood, and a disclosure that demographic data will be maintained on the patient.
  • Some states have passed legislation requiring physicians to inform their patients about umbilical cord blood banking options. Clinicians should consult their state medical associations for more information regarding state laws.
  • Directed donation of umbilical cord blood should be considered when there is a specific diagnosis of a disease known to be treatable by hematopoietic transplant for an immediate family member.
  • Obstetric providers are not obligated to obtain consent for private umbilical cord blood banking.
  • The collection should not alter routine practice for the timing of umbilical cord clamping.
  • Physicians or other professionals who recruit pregnant women and their families for for-profit umbilical cord blood banking should disclose any financial interests or other potential conflicts of interest.

American Academy of Pediatrics

The American Academy of Pediatrics also has a policy statement out on cord blood banking.  Their recommendations are similiar to ACOG.

  • Cord blood donation should be discouraged when cord blood stored in a bank is to be directed for later personal or family use, because most conditions that might be helped by cord blood stem cells already exist in the infant’s cord blood (ie, premalignant changes in stem cells). Physicians should be aware of the unsubstantiated claims of private cord blood banks made to future parents that promise to insure infants or family members against serious illnesses in the future by use of the stem cells contained in cord blood. Although not standard of care, directed cord blood banking should be encouraged when there is knowledge of a full sibling in the family with a medical condition (malignant or genetic) that could potentially benefit from cord blood transplantation.
  • Cord blood donation should be encouraged when the cord blood is stored in a bank for public use. Parents should recognize that genetic (eg, chromosomal abnormalities) and infectious disease testing is performed on the cord blood and that if abnormalities are identified, they will be notified. Parents should also be informed that the cord blood banked in a public program may not be accessible for future private use.
  • Because there are no scientific data at the present time to support autologous cord blood banking and given the difficulty of making an accurate estimate of the need for autologous transplantation and the ready availability of allogeneic transplantation, private storage of cord blood as “biological insurance” should be discouraged. Cord blood banks should comply with national accreditation standards developed by the Foundation for the Accreditation of Cellular Therapy (FACT), the US Food and Drug Administration (FDA), the Federal Trade Commission, and similar state agencies.
Online Resources on Cord Blood Banking to Share with FamiliesParents Guide to Cord Blood Foundation

American College of Nurse–Midwives—“Cord Blood Banking—What It’s All About” (from 2008 Journal of Midwifery & Women’s Health53[2], 161–162)

National Marrow Donor Program—“Cord Blood Donation: Frequently Asked Questions”

compiled by Renece Waller-Wise

I will provide this information to the family who asked me.  I will encourage them to talk to their doctor or midwife, and determine if it is appropriate for them to consult with a genetic counselor, to address family history and other information that may make it more likely for this child or another family member to need collected cord blood.

I would also provide information on the timing of umbilical cord clamping and suggest they discuss with knowledgable providers and the potential bank, the likelihood of an adequate collection when cord clamping is delayed.

After receiving this information from a variety of sources, I trust the parents will be able to make a decision that feels appropriate to them and I will feel that I have provided evidenced based sources that they found useful in their decision-making process.

How do you answer the question “Should we private bank our baby’s cord blood?” What do you say?  What have been your favorite resources on this topic?  Please share information that you feel we can all benefit from.  I welcome your discussion.

References

American Academy of Pediatrics:Policy Statement: Cord blood banking for potential future transplantation.  PEDIATRICS Vol. 119 No. 1 January 1, 2007 pp. 165 -170 (doi: 10.1542/peds.2006-2901)

American Congress of Obstetricians and Gynecologists. (2008) Umbilical Cord Blood Banking. ACOG Committee Opinion No. 399. Obstet Gynecol 2008;111:475–7.

Cord Blood Registry. (2009). Cord blood spotlight: Childbirth educator’s guide, 1(2), 1–4.

Drew, D. (2005). Umbilical cord blood banking: A rich source of stem cells for transplant. Advance for Nurse Practitioners, 13(Suppl. 4), S2–S7.

Fox, N. S., Stevens, C., Cuibotariu, R., Rubinstein, P., McCullough, L. B., & Chervenak, F. A. (2007). Umbilical cord blood collection: Do patients really understand? Journal of Perinatal Medicine, 35, 314–321.

Gonzalez-Ryan, L., VanSyckle, K., Coyne, K. D., & Glover, N. (2000). Umbilical cord blood banking: Procedural and ethical concerns for this new birth option. Pediatric Nursing, 26(1), 105–110.

Percer, B. (2009). Umbilical cord blood banking: Helping parents make informed choices. Nursing for Women’s Health, 13(3), 216–223

Sullivan, M. J. (2008). Banking on cord blood stem cells. Nature Reviews Cancer, 8, 554–563

Waller-Wise, Renece. (2011) Umbilical cord blood: information for childbirth educators. Journal of Perinatal Education, 20(1), 54–60, doi: 10.1891/1058-1243.20.1.54

Washington State Legislature, Revised Code of Washington 70.54.220 Practitioners to provide information on prenatal testing and cord blood banking. http://apps.leg.wa.gov/rcw/default.aspx?cite=70.54.220  Accessed September 21, 2012.

Wolf, S. (1998). Cord blood banking: A promising new technology. Neonatal Network, 17(4), 5–6.Wolf, S. (1999). Storing lifeblood: Cord blood stem cell banking. American Journal of Nursing, 99(8), 60–68.

 

Babies, Childbirth Education, Delayed Cord Clamping, Evidence Based Medicine, Healthy Birth Practices, Healthy Care Practices, informed Consent, Journal of Perinatal Education, Newborns, Research, Third Stage, Uncategorized , , , , , , , , , ,

Kimmelin Hull Steps Down as Science & Sensibility Community Manager

April 4th, 2012 by avatar

Dear Science & Sensibility readers,

It is with deep regret that I announce my resignation from the post of Community Manager of this blog site. As you may know, I suffered a head injury in mid-January, resulting in my medical leave of absence over the past 2 ½ months. Lamaze has been incredibly generous in their support of me during this time; we had all hoped I would be able to resume the helm by the end of April.

Unfortunately, my recovery has been slow and far from complete. At this time, it makes the most sense to encourage a longer term replacement. Thanks to Deena Blumenfeld, Lisa Baker and Kathy Morelli for their enthusiastic assumption of Guest Manager posts during these past three months.

It has been an honor and privilege to serve Lamaze International and you, the reader of Science & Sensibility. I encourage all of you to keep reading, writing and discovering the best ways to practice evidence-based care of perinatal women, babies and families.

Respectfully,

Kimmelin Hull, PA, LCCE, FACCE

Call for Applicants: Community Manager, Science & Sensibility

Lamaze International is searching for a new Community Manager to take the lead on Science & Sensibility. This is a prime opportunity for experienced bloggers who have an online presence and demonstrated commitment to advancing evidence-based birth practices.   Interested applicants should submit a letter describing qualifications and vision, along with a current resume to Linda Harmon, Executive Director by April 16, 2012 at director@lamaze.org.

About Science & Sensibility

Science & Sensibility is a multi-disciplinary blog launched in April 2009 by Lamaze International to improve knowledge of evidence-base maternity care among Lamaze Certified Childbirth Educators and other birth professionals and advocates.  It is one of the leading online resources for up-to-date news and analysis of research and policy issues affecting childbearing women.

Eligibility Criteria

The eligibility criteria for appointment shall include, but not be limited to, the following:

  •     Demonstrated commitment to advancing safe and healthy birth and to the Lamaze approach to pregnancy, birth, breastfeeding and parenting.
  • Knowledge of the fields of maternity care and perinatal education and their current trends and advances.
  • Knowledge of evidence-based maternity care and the limitations of evidence.
  • Reputation as an online presence advocating for safe and healthy birth preferred.
  • Progressive vision for the role Science & Sensibility can play in disseminating knowledge and shaping conversations.
  • Experience writing for a blog. (Experience writing for peer-reviewed publication(s) preferred.)
  • Knowledge of WordPress or other blogging platform.
  • Demonstrated ability to plan, coordinate, and manage tasks associated with a multi-contributor blog.
  • Lamaze-Certified Childbirth Educator preferred.

Term

After the successful completion of a two (2) month probation period, the Community Manager will be appointed for a two (2) year term and may be renewed for additional two (2) year terms.

Remuneration

Lamaze International will provide the Editor with a quarterly honorarium of $2,500 ($10,000 annually) and provides marketing and IT support as needed.

General Responsibilities

The Community Manager of Science & Sensibility is directly accountable to the Lamaze International Executive Director. The Community Manager is responsible for all aspects of preparing the content of Science & Sensibility for publication, and is responsible for engaging with other bloggers on collaborative efforts. The specific responsibilities include:

  •  Prepare or solicit from contributors at least 8-10 blog posts per month and coordinate publication schedule.
  • Edit and prepare all content for publication in WordPress.
  • Work with new contributors to provide supportive and constructive feedback on blog submissions, and identify and appoint new contributors as needed.
  • Monitor and engage with other blogs covering issues that impact maternity care research and policy.
  • Participate in or coordinate online community events including collaborative writing projects and blog carnivals.
  • Manage Science & Sensibility Facebook page and participate in Twitter communication.
  • Moderate blog comments, and establish and enforce Community policies (e.g., commenting policy, editorial policies, etc.).
  • Participate in monthly phone calls with the Lamaze social media team and the Lamaze Institute for Safe and Healthy Birth.
  • Contribute periodic research summaries or articles based for publication in The Journal of Perinatal Education.
  • Provide periodic reports on Science & Sensibility as requested.

 

 

Uncategorized , , , ,

A Follow Up: Maternal Obesity from All Sides

November 7th, 2011 by avatar

Science & Sensibility readers may recall the Maternal Obesity from all Sides series* we did a few months ago.  Last week, while walking my dog and catching up on a few news podcasts, I heard this story on NPR’s Morning Edition—a segment that was a part of the news outlet’s series on Obesity in America.  The story discusses new research that looks at why it can be so difficult to lose and keep weight off from a hormonal and biological perspective.  The gist of the research referenced in this news piece is that when we concertedly work to lose weight, our body produces less of the hormone leptin (a natural appetite suppressant) which prompts a starvation signal in our brain, telling the body to conserve energy by decreasing metabolism and, at the same time, feel more hungry—prompting increased caloric intake.

Additionally, the Morning Edition segment made the point that once a person has gained more weight than that which is healthy for his/her stature, it becomes harder and harder to lose and keep the weight off.  As the reporter summarizes, “lower metabolism lasts a lifetime.”  (Despite this, some excellent points are later made in the segment which suggest that moderate exercise six days a week—such as brisk walking, swimming or cycling, can have positive effects on weight loss and maintenance.)

What does all this have to do with maternity care issues?

Well, in the Maternal Obesity from all Sides series, we discussed the growing correlations between maternal overweight and pregnancy and L&D outcomes:  how women of size are more likely to experience gestational hypertension and diabetes; how they are more likely to be offered labor inductions and undergo cesarean deliveries as a result of those comorbidities—whether or not those procedures are actually evidence-based for the given situation(s).  And we also discussed how addressing size and/or weight once a woman is pregnant is both unfruitful and unfair—because most of us recognize that pregnancy is not a time when a woman should be attempting to lose weight.  Likewise, it is not a time when a woman should be shamed for a preexisting condition (as if shaming is ever acceptable).

But, in the spirit of preventative care, I felt the NPR piece was enlightening: while there are MANY opportunities to improve maternal outcomes through preconception/interconception care, as pointed out in the recent blog post by Christine Morton, and the more distant series by Walker Karraa, perhaps working to prevent obesity in the first place—rather than focusing on after-the-fact individual or public health weight loss programming—is a better approach.  Because, according to the news segment linked to above, once extra weight has been acquired, losing and maintaining that weight loss is exceptionally more difficult.

A similar NPR story on All Things Considered aired just a few days earlier which covered this same topic and reviewed the findings of a study recently published in the New England Journal of Medicine.  The study by Priya Sumithran et al. assessed the hormone and metabolism changes that accompanied significant weight loss in severely calorie-restricted study subjects.  As described in the Morning Edition segment, Sumithran’s study described significant weight loss maintenance difficulties that were hormonally based.  In essence: maintaining weight loss is about hormones, not will power.

Women of childbearing age have enough maternity care-related challenges to face: escalating labor induction and cesarean delivery rates, racial disparities in access to care.  We talk a lot on this blog site about the cascade of interventions, a concept that is also frequently referred to in Lamaze teachings.  Perhaps it is time we should also be talking about a healthy cascade of prevention, with maternal obesity being a prime target.  Ideally this cascade of prevention begins well before women of childbearing age find themselves contemplating pregnancy, or preparing for birth.  But even as childbirth educators, we can play a part in this healthy cascade.  When covering postpartum topics, we can talk with our expectant parents about the importance of interconception health:  nutritious dietary choices and adequate exercise.  We can couch these discussions as approaches to optimizing health in various ways with various downstream benefits:  having adequate energy to play with one’s child(ren), reducing a family’s healthcare cost burden, and yes, laying the ground work for healthfully supporting a future pregnancy if and when that occurs.

As Dr. Miranda Waggoner stated in her interview with Dr. Morton, “…we do have to worry about viewing women as pregnancy vessels,” but I also think we need to begin looking at expectant women beyond just the here and now.

 

*The Maternal Obesity from All Sides series is also reviewed in the current Journal of Perinatal Education.  If you don’t already receive the JPE and would like to check it out, you can request a free copy of the journal here.

 

 

Posted by:  Kimmelin Hull, PA, LCCE, FACCE

Maternal Obesity , , , , , , , , , , ,

What Are We Doing Now? Some Updates from Your S&S Writing Crew…

September 8th, 2011 by avatar

As summer approaches its end, fall just around the corner, I find myself settling into a new schedule.  Children back in school and summer travels dispensed of, it’s time to get my nose back to the grindstone.  This will look a bit different for me this year.  Along with my work here at Science & Sensibility, I have begun my studies in the School of Public Health at the University of Minnesota where I am pursing my Masters of Public Health ~ Maternal & Child Health.  Before any of that gets well under way, I will attend Lamaze’s 2011 Annual Conference in Fort Worth, Texas next week where I will conduct a breakout session, Social Media for the Childbirth Educator:  Helpful or Hindrance?  Five hours after delivering this session, I will virtually (via pre-recorded video) be apart of a panel discussion at the Postpartum Support International conference in Seattle, WA , to discuss issues pertaining to postpartum mood disorders, childbirth educators and social media users—along with the other panelists, Penny Simkin,  Nancy Lantz, Emily Dossett, and Walker Karraa.

Having recently submitted a midwifery-geared textbook chapter to a publisher in the U.K., I expect to do some editorial work on that in the coming weeks/months.  And speaking of editing, I am enjoying do a little substantive editing on childbirth education video scripts for the primary childbirth ed. video production company in the U.S.

Apparently, I am not the only one with a bursting-at-the-seams schedule.  Here are some updates from a few of the other Science & Sensibility contributing writers to keep you up-to-date on the work we are doing to improve maternity care for moms and babies:

 

Jackie Levine, LCCE, FACCE, CD(DONA), CLC:  After a hiatus of 6 summertime weeks, Jacqueline (Jackie) Levine will be back at her local Planned Parenthood Center teaching Lamaze classes to the pregnant clientele and their families.  Remember, 97% of Planned Parenthood’s services are directed towards providing essential health care for women in the communities they serve. All women in her classes get free labor support and post partum breastfeeding support. She will teach her fall class on the history and policies of childbirth in America at CW Post as a guest lecturer, will teach breast feeding classes for DONA certification candidates,   resume the research-and-writing of RPFs for her doula group, the Long Island Doula Association, and will continue to be an enthusiastic contributor to and supporter of Science and Sensibility.

 

Penny Simkin, PT:  In the coming months, Penny Simkin will participate in several childbirth conferences, among them a 5-days trip to Iceland to give talks and trainings for childbirth professionals. She will also teach a full schedule of childbirth and sibling classes, and will attend the births of a few doula clients who are due in the next few months. She will be working with DONA International on revising the birth doula manual, and has a few other irons in the fire, including a new DVD for siblings-to-be.

Henci Goer: In August, Henci Goer turned in the manuscript (at last!) for a top-to-bottom new edition of Obstetric Myths Versus Research Realities, co-authored by Amy Romano, to its publisher, University of Michigan Press. The working title is Obstetric Myths Versus Research Realities: Optimal Practices and Obstacles to Implementation. She is not, however, resting on her laurels. She is planning on doing a new edition of Thinking Woman’s Guide to a Better Birth that will make use of the updated research gathered for the second edition of Ob Myths. She also will be updating her talks for her fall speaking engagements in Austin, TX; Burbank, CA; Niagara Falls, Ontario; and Moscow, Russia. (See http://hencigoer.com/talks/ for further info.) Now that the big push to get the manuscript done is over, Henci also looks forward to resuming writing blog posts for S&S. In addition, she will be doing a guest appearance on Lamaze’s Facebook page in October, and will, of course, continue with responding to questions and moderating her Lamaze forum, “Ask Henci.”

Edith Kernerman, IBCLC:  Well,  8 weeks to go before my biggest project is due:  crazy about babies, though—they don’t exactly come when you hope they will!   In my case, I am one of those unusual expectant mothers who hopes the little one will come a bit on the late side (my last 2 did!)—not so late that I have to deal with “the system” but late enough so I can finish all that I have to do before then!

So, what is all of that?  I have an e-book on the GamePlan for Protecting and Supporting Breastfeeding in the 24 hours of Life and Beyond (based on the booklet of the same name that has been out since 2006) that I have just finished and sent for editing—so, let’s hope my editor finds no fault and sends it back with no revisions…yeah…right…!  There’s a chapter I must start writing on how the healthcare system supports breastfeeding (or doesn’t), and this is due in October for a book coming out of Australia.  I have another chapter on Pain due for someone else’s book from North America.  I am presenting a talk at the Association of Perinatal Naturopathic Doctors in mid-October on Mammary Constriction Syndrome.  And we are just finishing the study design for the big study on Mammary Constriction Syndrome (following in the footsteps of our pilot study) that we are hoping to team up with a pediatric cardiologist who works with Doppler so we can measure changes in blood flow to the breasts while mothers are experiencing pain.  I am also co-teaching a 2-day workshop in mid-September on Beyond the 20 hour Course in the London, Ontario area.  I have also been working on the iphone app for the L-eat Latch and Transfer Tool, and the electronic charting version of the L-eat for Hospitals (quite late on that as I was asked for this 2 years ago!).    I think I am a couple of blogs behind for Science & Sensibility, I am 4 blogs behind for www.BabyLatch.com  and I have 2 due for www.BreastFeedingInc.ca  and another for www.nbci.ca .  All the above needs to get done before the end of October, while I am working every day in the clinic seeing moms and babes, overseeing IBLCE Pathway 3 students and NBC diploma students and Midwifery and med students on rotation, supervising clinical and administrative staff, and helping to get our 3 new wonderful docs comfortable before my mat leave—all at our International Breastfeeding Centre’s Newman Breastfeeding Clinic in Toronto.   Oh, and I forgot to mention that my book, Breastfeeding the Baby Who Does Not Latch is so behind deadline I can’t even think about it!

Amy Romano, MSN, CNM: I continue to work for Childbirth Connection as the Project Director for the Transforming Maternity Care Partnership. This fall I’ll be dedicating a lot of my time toward our shared decision making initiative, a collaboration with the Foundation for Informed Medical Decision Making. I’ll also continue to oversee the Transforming Maternity Care web site and blog, which offer tons of resources for maternity care quality improvement. 

This fall also marks two major writing milestones. On October 1, the 9th edition of Our Bodies, Ourselves will hit bookstores. I was one of the editors of this edition, responsible for the pregnancy, birth, and postpartum chapters as well as one chapter on navigating the health system. I’ll be attending a global symposium on women’s health and human rights in Boston, an event that will celebrate the 40th anniversary of the landmark book. In addition, Henci Goer and I have recently submitted the manuscript for Obstetric Myths vs. Research Realities (finally!) and I expect to be working through the editorial process on that book as well.  One of the events on my fall calendar that I’m most excited about is my local Nurse-Midwifery Week event which will feature several speakers including Science & Sensibility’s own Tricia Pil, discussing patient safety in maternity care. On a personal note, my “baby” starts kindergarten this fall and my daughter (who was born just a few weeks after I started working for Lamaze) starts 2nd grade!

Kathleen Kendall-Tackett, Ph.D., IBCLC:  Kathleen has a number of exciting projects that she will be working on  this Fall. She started a small publishing company focusing on women’s health in March, 2011 (www.PraeclarusPress.com). She currently has five books under contract and has already received one manuscript. Several others are due by the end of the year. Dr. Kendall-Tackett will also be working on the December issue of the journal, Clinical Lactation in her capacity as editor-in-chief. The upcoming issue has some great articles including an article on ergonomic principles to help prevent pain in breastfeeding mothers, another on breast massage and hand expression, and still another on breastfeeding folklore in American Indians. She will also be finishing her term as associate editor of the journal, Psychological Trauma.

Kathleen and her colleagues, Tom Hale and Zhen Cong, have been analyzing data from their Survey of Mothers’ Sleep and Fatigue. This latest set of analyses focuses on the impact of sexual assault on women’s sleep and depression risk postpartum. The sample includes 6410 women from 59 countries, including 994 women who have reported sexual assault. The first two papers from this study can be found at http://www.kathleenkendall-tackett.com/research-projects.html. And I’ll round out the year with a lot of conferences across the U.S. and the Laktation und Stillen conference in Berlin, and a breastfeeding conference sponsored by the Belgian government at the University of Ghent. It’s looking like a busy, but really interesting, fall.

Tricia Pil, MD:  In October, Tricia is looking forward to traveling to New Haven to speak at the annual Midwifery Week Celebration for the Connecticut nurse-midwives association, which is being hosted and organized by former S&S Community Manager and current Childbirth Connection associate program director Amy Romano. She also has a letter-to-the-editor forthcoming in the American Journal of Obstetrics and Gynecology that provides a critical analysis of an obstetrics patient safety program at a major academic medical center, and she will be sharing that with S&S readers as soon as it is published.

Christine Morton, PhD continues to work at CMQCC – where projects underway include ongoing data analysis of the CA-PAMR Pregnancy Associated Mortality Review.   CMQCC will focus its next toolkit on Preeclampsia/Eclampsia, which emerged as the second leading cause of death in the CA PAMR findings.She is also co-authoring a white paper on the rising Cesarean Delivery rate in California and identifies promising Quality Improvement Opportunities in the domains of clinical care and payment reform.   Christine is engaged in two collaborative research projects with social science colleagues–one is a study of traumatic childbearing experiences (interviews with women, their support persons and providers) and the other is a national survey to be released early next year to all labor & delivery nurses, childbirth educators and doulas about their attitudes and practices on routine interventions in childbirth.  She is also slowly making progress on her book manuscript on doula care based on her dissertation research.

 

 

 

 

 

 

 

 

 

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