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Book Review: Optimal Care in Childbirth: The Case for a Physiologic Approach Reviewed Through a Childbirth Educator’s Eyes

October 18th, 2012 by avatar

I had waited excitedly for the release of Henci Goer and Amy Romano’s new book for a long time and was delighted to receive it after it was published in May 2012. Optimal Care in Childbirth: The Case for a Physiologic Approach was a robust, updated successor to Henci’s previous book; Obstetric Myths Versus Research Realities which was a well used source on my office bookshelf.

Both authors have a long history with Lamaze International. Prior to her current position with Childbirth Connection, directing the Transforming Maternity Care Partnership, Amy launched Science & Sensibility, and provided a keen and critical eye when analyzing, reviewing and sharing research items with readers. Henci Goer has been the long time resident expert on the “Ask Henci” forum hosted by Lamaze International, providing and sharing resources on a wide variety of pregnancy and childbirth topics with consumers and professionals alike, as well as a regular contributor to this blog. Please read the full bios of Amy and Henci on their website, where you can find complete information on their work, background and other works that they have authored.

As the title clearly states, this book is about childbirth, and as such, you will not find information on pregnancy, breastfeeding or newborn topics. Nor is this the type of text that childbirth educators would hand out in class for consumers to use. This book is heavy with sources, study outcomes and insights into current obstetric practices. But, as a guide to best practice, the book becomes a great repository of information that allows consumers and professionals alike to learn and make decisions about care that can help keep birth as physiological as possible. The book focuses on what factors affect, both positively and negatively, birth, so that an optimal outcome can occur.

The authors define optimal outcomes as “the highest probability of spontaneous birth of a healthy baby to a healthy mother, who feels pleased with herself and her caregivers, ready for the challenges of motherhood, attached to her baby, and goes on to breastfeed successfully.”

The chapters are well organized, with the topic of cesareans starting things off. Cesarean rates have never been higher, and many of the topics that Goer and Romano discuss later in the book often have the unintended consequence of contributing to the skyrocketing cesarean rates in this country. I think it is an important topic and one that receives a thorough evaluation by the authors.

Each chapter starts off with “contradicting” quotes from researchers working in the field of obstetrics, and I have to say, that reading these at the beginning of each chapter was something I looked forward to, a nice added bonus and really made me pause and consider the different viewpoints and how they influence practice today. The lead in for chapter 12 on epidurals and spinals contains one of my favorites:

“There is no other circumstance in which it is considered acceptable for a person to experience untreated severe pain, amenable to safe interventions, while under a physician’s care.” ACOG 2006

“Epidural anaesthesia remains one of childbirth’s best exemplars of iatrogenesis. It is a wonderful intervention for managing labour complications, especially as an alternative to general anaesthetic for caesarean sections, but has significant side effects that constantly need weighing alongside benefits. Though its rising popularity almost grants it the status of normative practice on some [U.K.] maternity unites, it remains incompatable with physiological labour.” Walsh 2007

Each chapter begins with a wonderful perspective on each topic, sharing history and cultural practices so the reader can understand how standard protocols found in most birthing facilities have come to be, even when not backed up by research. I think it is critical to include this information, for if there is to be a shift to more evidence based care in the field of obstetrics, we need to be aware and acknowledge that some practices may have evolved for legal, cultural, social or policy reasons having nothing to do with sound research.

The authors ask and answer the very questions that I find myself asking out loud, helping the reader to understand why we continually observe care that is known to not improve outcomes. For example, when discussing electronic fetal monitoring, the question “Why does use of continuous EFM persist?” in normal low risk labors is asked (and thoroughly answered) with supporting references for further information.

Each chapter contains a brief summary of action steps that women can take to receive optimal care, along with the supporting research that backs up these steps. These lists are great talking points both for educators to integrate in their classrooms, but also for consumers to discuss with their health care providers and understand why their care might deviate from that supported by research.

The conclusion of each chapter has what the authors call a “mini-review” and neatly summarizes the important topic statements and provides (and references) outcomes of studies so that the reader can evaluate for himself or herself the validity of the research. Though these sections are called reviews, I found them to be a very helpful component of the book, when looking for solid sources.

At the end of each chapter, all of the sources referenced in that chapter are listed.

Henci Goer

I was very appreciative throughout the book, for the definitions that the authors provided when discussing a topic. It is important (and helpful) to know how terms are defined, so that the reader can best understand the discussion. For example, in one of the cesarean chapters, one can find a list of “rate” terms, so when “primaparous cesarean rate” is discussed, this term has already been explained.

Several places throughout the book, in various callout boxes, Goer and Romano discussed the selective language that health care providers use when talking about childbirth and presenting information to families. I found these small detours fascinating, as I am very interested in the language that HCPs use to discuss risk, procedures and events with their patients.

The last chapters of the book take a look at choice of birth location, what the ideal maternity care system might include and includes information on maternal mental health. The appendices speak to common “less than optimal” situations, such as the OP fetus in labor, meconium staining and other circumstances that frequently cause concern and labor interventions. Again, the authors include information on optimal care in these cases that can help.

It is clear from some of the phrasing, chapter titles and choice of words in some of the discussions, that the authors have a bias towards a childbirth process that unfolds in a natural and physiological manner. This language, while potentially off-putting to those who firmly believe in the medical model, is effective in causing the reader to consider standard practices that make no logical “sense”, and certainly, references are provided for further research should the reader wish to investigate further.

I must say that I very much enjoyed this book, and I will find it very useful in my doula and Lamaze childbirth education practice. It is the type of book that one thumbs through frequently, when asked a question by a student or client, or when helping a client to prepare to speak to their health care provider about best practices and birth preferences. I think that any birth professional would do well to have this book on their shelf and be able to refer to it when necessary. This book represents a significant amount of research and I find great comfort in knowing that all the resources and references supporting the statements made in the book are available for me to source myself.

Amy Romano

I look forward to the release of the e-book version of this title, expected this fall, for the Kindle, iPad and other tablets, so that I could have easy access from wherever I am. I would be delighted if the references and sources could be routinely updated as new research is released and published, so that I can use this guide for many years to come, confident that it reflects the newest and most valid research. I know that is a formidable task, but I would gladly pay a small subscription fee to have an updated version as often as necessary.

This book is available for purchase from both Amazon.com and the Optimal Care in Childbirth website. The book is on the expensive side, costing approximately $50.00, but very well may become the go-to source for evidenced based research on your office shelf, so worth the investment. If you choose to purchase from the book’s site, there are bulk and wholesale discounts available.  For purchases made from the book’s website, the authors are providing a 15% discount for our Science & Sensibility blog readers and conference attendees. Enter code UXJXI52F at checkout to receive the discount.

I hope that you are planning to attend the upcoming Lamaze International Innovative Learning Forum next week, where both Amy Romano and Henci Goer have been invited to speak. You will have an opportunity to meet these authors, ask them questions, purchase this book and hear their powerful presentations. As a General Session Speaker, Amy’s session will be available as part of the “Virtual Conference” option for those unable to attend the conference in person.

Have you read Optimal Care in Childbirth?  Are you using it already in your practice?  Please share your thoughts and comments in our comment section here on the blog.  I look forward to hearing your views. – SM

References

ACOG committee opinion. No. 339: Analgesia and cesarean delivery rates. Obstet Gynecol 206;107(6):1487-8.

Walsh D. Evidenced Based Care for Normal Labor and Birth. London: Routledge; 2007.

Book Reviews, Cesarean Birth, Childbirth Education, Epidural Analgesia, Fetal Monitoring, Healthcare Reform, informed Consent, Lamaze 2012 Annual Conference, Maternal Mental Health, Medical Interventions, New Research, Pain Management, Practice Guidelines, Research, Systematic Review, Transforming Maternity Care , , , , , , , , ,

Early Bird Prices for 2012 Lamaze Innovative Learning Forum Ends 9/24! Are You Registered?

September 18th, 2012 by avatar

 

The 2012 Lamaze Innovative Learning Forum is scheduled for October 26-28 in Nashville, TN and now is the time to sign up for this exciting learning and networking opportunity. This year’s conference theme is “Safe and Healthy Birth: The Music of Our Head, Heart and Hands” and Lamaze International is offering a new approach, which includes more opportunities for interaction among attendees with lower costs and less time away from work and family. Contact hours good for Lamaze, Nursing, ACNM, IBCLC re-certifications will be awarded for attendance at this continuing education event.

The internationally recognized General Session speakers include Ina May Gaskin, (Birth Works, Why Don’t More People in the U.S. Know it?), Dr. Jack Newman, (The First Hour),  Steven B. Frye, (Adult Learning and Conceptual Change: Putting Theory to Practice), and Abby Epstein, (The Accidental Birth Advocate).

In between general sessions, you will be treated to Interactive Learning Sessions, where the topics of Maternal Safety, Infant Safety and Evidenced Based Teaching and Practice will be highlighted in the categories of Head, Heart and Hands.  Leave these sessions full of ideas to take back with you and implement to make your classes, client relationships and professional knowledge more effective and useful to all.

Morning Learning Sessions, Exercise Sessions, Film and Poster Presentations and a full Exhibit Hall present additional opportunities to learn, shop, connect and participate in all the 2012 Lamaze Innovative Learning Forum has to offer.

The social event of the conference, “Papas and Mamas Sing For Healthy Birth” Benefit Concert is a partnership between Lamaze International and Attachment Parenting International to benefit and celebrate healthy birth scheduled for Saturday evening.  The concert will feature Grammy winner Delbert McClinton and The McCrary Sisters.

You can save $145 dollars on the forum registration fee if you register by Monday, September 24, 2012, when “early bird” registration closes. This represents significant savings and a great value for your continuing education and conference dollars.

Choose to attend the pre-Forum workshops and attend a Lamaze Childbirth Education Seminar facilitated by DUKE AHEC or the Lamaze Evidenced-Based Nursing Care: Labor Support Skills Workshop facilitated by Judith Lothian and take advantage of the bundled registration fee for the specialized workshops and the 2012 Forum, saving yourself $100 in the process.

Stay a few extra days in Nashville and treat yourself to a DONA International Birth Doula Workshop led by Patricia Predmore, DONA International Birth Doula Mentor. Attendance at this workshop and the Forum saves you $50 over purchasing the two registrations separately.

Click here to register for the conference and get “early bird” rates when you register to attend by September 24, 2012.  You can also connect with other Forum attendees to find a roommate or two to share in your hotel costs at the beautiful Sheraton Nashville Downtown Hotel and take advantage of the special Lamaze Forum room rate.  You do not want to miss the childbirth education event of the year.  Sign up now.

 

Babies, Childbirth Education, Conference Schedule, Continuing Education, Evidence Based Medicine, Films about Childbirth, Films about Pregnancy, Healthy Birth Practices, Healthy Care Practices, Lamaze 2012 Annual Conference, Newborns, Push for Your Baby, Uncategorized , , , , , , , , , , , , ,

“Six Healthy Conference Practices” Will Lead To Success At The 2012 Lamaze International Innovative Learning Forum!

August 14th, 2012 by avatar

Lamaze International’s “Six Healthy Conference Practices” will help you to have the best conference experience possible when you attend the 2012 Lamaze International Innovative Learning Forum, thereby insuring a rewarding, satisfying and fun learning opportunity.

This year, Lamaze International is offering childbirth educators and birth professionals, including lactation consultants, doulas, midwives, physicians, perinatal fitness instructors, perinatal education managers, L&D nurses and more, a unique opportunity to enjoy a rich and participatory learning experience in the beautiful city of Nashville, Tennessee on October 26-28, 2012 at the Sheraton Nashville Downtown Hotel.

The theme of the the Innovative Learning Forum is “Safe & Healthy Birth: The Music of Our Head, Heart & Hands” and is a wonderful recognition of the varied and extensive contribution Nashville has made to American music.  Nashville is known as “Music City” for good reason.  The Nashville Tourism website sums it up beautifully:

There’s a place where music lives. A place where music hangs its hat and puts its feet up on the furniture. A place where people don’t just talk about songs and CDs and lyrics, but live them night and day. That place is Nashville. Music City.

But, while music is the lifeblood of Nashville, visitors will also find a city of culture and history, of haute cuisine, of pro sports, outstanding academics, natural beauty and pure Southern charm. Nashville is a place where the past and the future peacefully coexist and build, one on the other, to create a destination that appeals to the interests of every visitor. This city is alive. You can feel its pulse when you walk down its sidewalks. And, fortunately, you can also hear it almost anywhere you go.

While exploring the city and all it has to offer during breaks in the Learning Forum will surely be enjoyable, the real music (and magic) will be happening in the conference location, where men and women from around the world will be gathering to share, learn, discuss, collaborate, plan and dream about supporting pregnancies, labors, births and parenting experiences that are grounded in science, and offer safety and respect to all families on the road to parenthood.

The Six Healthy Conference Practices include:

1. Taking advantage of pre-conference workshops that maximize your learning and minimize your travel expenses.

Participate in a pre-conference workshop for nurses by attending the Lamaze Evidence-Based Nursing Care: Labor Support Skills Workshop with Judith Lothian, PhD, RN, LCCE, FACCE on Thursday, October 25, or the Lamaze Childbirth Educator Seminar presented by the Lamaze Accredited Childbirth Educator Program at Duke AHEC, Wed., October 24-Friday, October 26.

2. Enjoying presentations by four well-known keynote speakers, leaders in the field of pregnancy, birth, breastfeeding and parenting.

The keynote speakers this year will be offering information on four topics of interest to birth professionals;

  • Maternal Safety will be addressed by Ina May Gaskin, PhD (Hon.), MA, CPM.
  • Evidence Based Teaching and Practice will be highlighted by Steven B. Frye, PhD, MA, MDiv, ThM.
  • Infant Safety will be covered by Jack Newman, MD, FRCPC and
  • Media and Marketing will be presented by Abby Epstein

3. Participating in learning opportunities all weekend long that earn you continuing education and contact hours.

Join your choice of interactive learning sessions, with a list of presenters who are guaranteed to be engaging, dynamic and memorable. Attend film showings, review the poster presentations and participate in morning exercise sessions throughout the weekend.  You will leave energized and exposed to new research and trends and teaching ideas sure to enrich your own classes.  The learning opportunities will be bountiful during your entire time at the conference as Lamaze provides you with an interactive breakdown of the preceding keynote sessions into three different perspectives: Head, Heart and Hands.

4. Getting a taste of Nashville and southern hospitality by joining in on Friday and Saturday night organized social events.

The best restaurants in Nashville have Lamaze International at the top of their reservation list, with tables reserved just for conference attendees on Friday night all around town.  Saturday night finds you kicking up your heels and tapping your toes to the best line-up of singers, songwriters and musicians the city has to offer at the “Music City Celebration.”

5. Networking, meeting new friends and reconnecting with old ones can be a top priority.

The opportunity to meet and mingle, share tasty refreshments and explore the exhibit hall and its many shopping opportunities with other birth professionals will be another highlight of this year’s conference.  People come from all over the world to attend (and exhibit at) the Lamaze International Conference every year, and this year will not be any different.  Meet the board members and staff of Lamaze International, attend the annual Lamaze membership meeting and applaud this year’s FACCE inductees.  There will be plenty of time to circulate, meet your colleagues from across the globe and discuss all the conference going-ons.

6. A 2012 Virtual Learning Forum experience is available for those who can not attend in person this year.

Lamaze International recognizes that not everyone who would like to attend the annual conference is able to join in person every year.  This year, if you find that traveling to the conference is not possible, please consider attending virtually from your home or workplace.  Better yet, join in with other professionals in your community and share that experience.  You will be able to register and participate virtually in the four keynote presentations, so you do not have to miss these exciting learning opportunities.

Register now! Early Bird Ends 9/24.

If you have not yet registered for the 2012 Lamaze International Innovative Learning Forum, please do not hesitate to register now!  Early registration allows you to take advantage of early bird conference pricing,which will save you significantly on conference fees,  guarantees you the special conference rate on housing at the hotel and will help you to have plenty of time to prepare travel plans and arrangements for what is sure to be a fun and exciting time in Nashville. Be sure to follow the Six Healthy Conference Practices to enjoy what will be the best conference ever!

Are you planning to go?  Do you need a roommate? What is getting you excited about the upcoming Innovative Learning Forum?  Will this be your first conference?  What have you enjoyed about previous conferences you have attended?  Share your plans,  thoughts and hopes for this conference in our comments and let us know that we can expect to see you! 

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2012 Lamaze Innovative Learning Forum Abstract Deadline

February 24th, 2012 by avatar

The abstract submission deadline for the 2012 Lamaze Innovative Learning Forum is March 5. This year, Lamaze is looking for presentations and hands-on sessions that build transferable skills among conference attendees. A select number of proposals are being accepted for this new conference format; please review the submission guidelines prior to submitting your abstract.

Share your expertise with hundreds of like-minded, passionate colleagues – submit your abstract online today!

We look forward to seeing you October 26-28 in Nashville, TN, to experience the new 2012 Lamaze Innovative Learning Forum: “Safe and Healthy Birth: The Music of Our Head, Heart and Hands.”

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