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April is Cesarean Awareness Month – Resources and a Test Your Knowledge Quiz

April 10th, 2014 by avatar

fb profile cam 2014April is Cesarean Awareness Month, an event meant to direct the American public’s attention to the United States’ high cesarean rate. 32.8% of all birthing women gave birth by cesarean in 2012. A cesarean delivery can be a life-saving procedure when used appropriately, but it takes one’s breath away when you consider that one third of all women birthing underwent major abdominal surgery in order to birth their babies.

Professionals that work with women during the childbearing year can be a great resource for women, pointing them to evidence based information, support groups and organizations that offer non-biased information to help women lower their risk of cesarean surgery, receive support after a cesarean and work towards a trial of labor after a cesarean (TOLAC) and achieve a vaginal birth after a cesarean (VBAC) for subsequent births if appropriate.

Here are my top suggestions for websites and resources every birth professional should have on their short list to share with students and clients when it comes to cesarean awareness.

1. International Cesarean Awareness Network – an international organization with almost 200 volunteer led chapters, (most in the USA) offering peer to peer support for cesarean recovery and VBAC information by way of a website, e-newsletters, webinars, online forums, Facebook groups and monthly meetings in the community.

2. VBACFacts.com – Led by birth advocate Jen Kamel, this website is big on research and helps consumers and professionals alike understand the evidence and risks and benefits of both repeat cesareans and vaginal birth after cesarean, including vaginal birth after multiple cesareans.

3. Lamaze International’s “Push for Your Baby” – is a great resource for families to learn about the Six Healthy Care Practices, what evidence based care looks like and how to work with your health care provider to advocate for a safe and healthy birth. Also Lamaze has an wonderful infographic that can be shared online or printed.

4. Spinning Babies – Midwife Gail Tully really knows her stuff when it comes to helping babies navigate the pelvis during labor and birth. Many cesareans are conducted for “failure to progress” or “cephalopelvic disproportion” when really it is a case of a malpositioned baby who needed to be in a different position. This website is a wealth of information on what women can do to help their babies into the ideal position to be born, prenatally and during labor. It includes valuable information about helping a breech baby turn vertex. This is important, because finding a health care provider who will support vaginal breech birth is like finding a needle in a haystack.

© Patti Ramos Photography

© Patti Ramos Photography

5. Childbirth Connection – This website is a virtual goldmine of evidence based information about cesareans and VBACs including a valuable guide “What Every Pregnant Woman Needs to Know about Cesareans.” There are questions to ask a care provider and includes information on informed consent and informed refusal.

6. Cesareanrates.com is a great website run by Jill Arnold for those who love the numbers. Find out the cesarean rates of hospitals in your area. All the states are represented and families can use the information when searching out a provider and choosing a facility. Jill’s resource page on this site is full of useful information as well.

7. Safe Prevention of the Primary Cesarean –  The American Congress of Obstetricians and Gynecologists along with the Society for Maternal Fetal Medicine recently published a groundbreaking document aimed at reducing the first cesarean. While fairly heavy reading, there is so much good information in this committee opinion that I believe every birth professional should at least take a peek. You may be pleasantly surprised.

Test your knowledge of the facts around cesareans and VBACs with this informative quiz:

As a birth professional, you can be a great resource for all your clients, helping them to prevent their first cesarean, providing support if they do birth by cesarean and assisting them on the journey to VBAC by pointing them to these valuable resources. You can make every day “Cesarean Awareness Day” for the families you work with, doing your part to help the pendulum to swing in the other direction, resulting in a reduction in our national cesarean rates and improving outcomes for mothers and babies. What are your favorite resources on the topic of cesareans and VBACs? Share with us in the comments section.
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Awards, Babies, Cesarean Birth, Healthcare Reform, Lamaze News, Maternal Mortality Rate, Maternal Obesity, New Research, Research, Webinars , , , , , , , , , , , ,

Lamaze International Webinar- Six is the New Four: A Review of the Safe Prevention of the Primary Cesarean Delivery Consensus Report

March 24th, 2014 by avatar

Lamaze International is delighted to be offering a continuing education opportunity for all interested professionals.  ”Six is the New Four: A Review of the Safe Prevention of the Primary Cesarean Delivery Consensus Report” is being facilitated by Richard Waldman, M.D. and Peggy DeZinno, BSN, RN, LCCE from OB-Consult on Tuesday, April 8th, 2014 at 4 PM EDT.

A few weeks ago, Science & Sensibility’s Judith Lothian highlighted and reviewed the just released joint ACOG/SMFM report “Safe Prevention of the Primary Cesarean Delivery” and many agreed it was a game changer.  Many of the recommendations listed in the report appeared to be shifting away from current, but outdated practices and encouraging more evidence based care that promotes patience, expectant management and acknowledges that protocols need to be changed if there is to be a reduction in cesareans, particularly that primary (first) cesarean.
In this upcoming webinar, Dr. Richard Waldman and Peggy DeZinno will discuss the gap between current practice and the opinion paper’s recommendations.  What will it take to get us there?  What needs to change and where are the challenges?
Dr. Waldman is the former president of the American Congress of Obstetricians and Gynecologists and a keynote speaker at the 2013 Lamaze International Annual Conference that was held in New Orleans, LA.  You can read an interview I did with Dr. Waldman last summer and also read his article, “Birth as the Ultimate Collaboration” that he wrote for Science & Sensibility in advance of his keynote presentation.
Co-presenter Peggy DeZinno, BSN, RN, LCCE provides OB-Gyn-specific risk management services at OB- Consult. She has over 35 years of experience in the healthcare industry, specifically as a coordinator and instructor of women’s health and education programs.
At the end of this webinar, learners will be able to:
  • List two reasons why the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine developed a Consensus for the safe prevention of primary Cesarean Delivery.
  • Describe the definition and management of abnormally progressing first-stage labor.
  • Describe the definition and management of abnormal second-stage labor
  • Discuss the role of continuous labor support in decreasing primary Cesarean births.

Participants in the full hour of the webinar will be able to receive 1.0 Lamaze Contact Hour and 1.0 Nursing Contact Hour after completion of a post-webinar evaluation. Lamaze International is an approved provider of continuing nursing education by the American Nurses Credentialing Center Commission on Accreditation.

This webinar and the associated continuing education hour is provide free as a benefit of Lamaze International membership.  Non-Lamaze members are invited to participate for the reasonable fee of $20, which includes the continuing ed contact hour.  Register for the webinar now to reserve your place at this exciting event scheduled for April 8th, 2014 ag 4:00 PM EDT.

ACOG, Childbirth Education, Continuing Education, Evidence Based Medicine, Maternal Quality Improvement, New Research, Webinars , , , , , , ,

Childbirth Connection Joins with the National Partnership for Women & Families – Everyone Benefits

March 20th, 2014 by avatar

national partnership women family logoA favorite resource for both myself as a childbirth educator and one that I share frequently with families in my classes has long been Childbirth Connection. Since 1918, when this organization was founded and known as the Maternity Center Association, they have been a “national voice for safe, effective and satisfying evidence based maternity care.”  Childbirth Connection accomplishes this by highlighting current issues and obstacles in maternity care, sharing evidence based information in easy to read and understand downloadable handouts and partnering with other organizations, including Lamaze International to lobby for and promote evidence based care for women and their families in the childbearing year.

You may be familiar with Childbirth Connection as the organization that has been conducting and publishing the landmark Listening to Mothers Surveys and Reports since the first of the LTM reports was published in 2002.  These comprehensive reports questioned mothers about their experiences from preconception through the postpartum period and shed light on many issues – including how much of the care women are receiving is not based on evidence and how limited many of the choices women are given for options while receiving care.  Information discovered through the surveys and published in the LTM reports has been enlightening and sometime shocking, as it highlighted the “real life” experiences of women around the country – who are experiencing maternity care currently in the USA.

Earlier this year, Childbirth Connection announced that they are becoming a core program of the National Partnership for Women & Families, a Washington DC based organization founded in 1971, whose mission is to improve health for women and families, and make the nation’s workplaces more fair and family friendly.  Each organization brings different strengths to the collaboration. Childbirth Connection has a long history of clinical and research focus programs based on evidence based care, while the National Partnership has long established relationships with policy makers.  The fit is a natural one that will benefit American women and mothers and improve maternity care in the USA.

One of the first publications released by Childbirth Connection, under the umbrella of the National Partnership for Women & Families, was a report; “Listening to Mothers: The Experiences of Expecting and New Mothers in the Workplace.” This report was prepared from information gathered during the most recent LTM III survey.

Some key findings from this report include:

  • Holding a job during pregnancy is the new normal.  In fact, women are the primary or sole breadwinner in over 40% of families with children.
  • Women often need minor adjustments on the job to protect their health during pregnancy. 71% of women needed more frequent bathroom break and 61% of women needed some schedule modification or time off in order to attend crticial prenatal health care appointments.
  • Pregnant women’s need for accommodation often goes unspoken and may be unmet, or are often denied.  Many women do not speak up out of fear of repercussions, refusal or uncertainty about how their request will be viewed.
  • Less economically advantaged women are in greater need of accommodation than more advantaged women. Women of color, lower educated women and women who held part time jobs needed more accomodation.
  • Upon returning to work, new mothers experience bias, lost pay, loss of responsibilities and other actions, including losing their job altogether. More than one in four women reported experiencing bias from their employers due to perceptions of their “desire, ability, or commitment” to doing their jobs.
  • Breastfeeding remains a challenge for employed new mothers.  58% of women reported that breastfeeding while employed presented obstacles, including employers not providing an appropriate clean and private location or adequate breaks in which to express milk.

childbirth connectionAs childbirth educators, the women in our classes most likely are working outside the home and many will return to work after having their children.  These are issues that they will face no matter where they are located in the USA, and as educators we can sympathize with their situation and provide concrete resources to help them problem solve solutions.  The National Partnership for Women & Families/Childbirth Connection should be on the short list as a great resource for these women.  We can also share our own tips, encourage discussion amongst the families and help prepare them for some of the above challenges that they may face.

Congratulations to Childbirth Connection on this new opportunity!  I am looking forward to reading and sharing future work done by your organization and in cooperation with the National Partnership for Women & Families.  Educators and others – what information do you feel is important to share with your families about working while pregnant, returning to work after birth and maintaining the breastfeeding relationship once your students are working again.  Comment with your suggestions, advice and resources, so that we can all offer the best information to all families.

References

Declercq, E. R., Sakala, C., Corry, M. P., Applebaum, S., & Herrlich, A. (2013). Listening to Mothers III: New Mothers Speak Out. New York, NY: Childbirth Connection.

 

 

 

 

 

 

 

Babies, Childbirth Education, Maternal Quality Improvement, Maternity Care, Transforming Maternity Care , , , ,

Is Your Favorite in the Top Five? – Science & Sensibility’s Five Most Popular Posts

March 13th, 2014 by avatar

I have been working as Science & Sensibility’s Community Manager for a few weeks shy of two years.  The past two years have been one of great growth for me personally, as I have stretched myself to explore and more clearly understand research related to maternal infant health. I have “labored” to choose topics that are of interest, current and relevant to our readers. I have deeply enjoyed supporting and collaborating with the many gifted writers who have been kind enough to share their wisdom and their words with all of us. I have welcomed and enjoyed the reader comments and shared discussions with many readers, as they made their opinions, thoughts and viewpoints known.  I have learned along with all of you, as readers asked questions of the blog writers and clarified their understanding of topics.  It has, to put it simply, been a fantastic and fun time.

As I reflected on the past two years , I wondered what have been the most popular posts on the blog, since Amy Romano wrote the first post on Science & Sensibility back in Spring of 2009.  I took a look and found some surprises.  I thought it would be interesting to share the top five posts and ask you, the reader – what posts have been your favorites?  The ones you share with students, clients and patients over and over? The ones you most enjoyed reading?

Top Five Posts on Science & Sensibility

#5. Research Review: Facilitating Autonomous Infant Hand Use During Breastfeeding

© Raphael Goetter

© Raphael Goetter

This post reviewed research by Catherine Watson Genna, BS, IBCLC, RLC and Diklah Barak, BOT that demonstrated that babies use their hands at the breast for many purposes, including stabilizing their neck and head for feeding, causing the nipple to become erect and increasing maternal oxytocin which facilitates delivery of milk to the infant.  The research paper included great photographs and links to videos documenting this behavior.  All the more reason to encourage mothers to unswaddle babies prior to feeding to allow them to do what they do best.

 

 

#4. Help New Mothers Breastfeed in Comfort: Nordstrom Converts Any Bra Into A Nursing Bra for a $10 Fee

Creative Commons Photo: Children's Bureau Centennial.  WPA Project 1938

© Children’s Bureau Centennial. WPA Project 1938

This post shared the little known fact that some Nordstrom stores in the USA would convert a woman’s favorite bra into a nursing bra for a small fee.  Many women find it difficult to find a comfortable nursing bra and are sad to need to stop wearing their favorites.  Now they may not have to.  We heard from lots of readers that not all stores offer this service and the price may vary. Updates would be welcome.

 

 

 

 

#3.  Safe Prevention of the Primary Cesarean Delivery: ACOG and SMFM Change the Game

acog wordlThis recent post by Judy Lothian, Phd, RN, LCCE, FACCE, highlighted the newly released ACOG and SMFM Consensus statement discussing 18 points that these organizations stated would help to reduce the number of primary cesareans being performed.  This statement was groundbreaking in its language, suggestions and proposed modifications to current obstetrical practice, backed up by evidence and certainly in line with much of the research behind Lamaze International’s Six Healthy Birth Practices.

 

#2. What Is the Evidence for Induction for Low Amniotic Fluid in a Healthy Pregnancy?

“It is standard of care in the U.S. to induce women with isolated oligohydramnios at term.” Image Source: http://www.flickr.com/photos/drewesque/2608674753/sizes/l/in/set-72157605814668384/

© drewesque

This post by Rebecca Dekker, Phd, RN, APRN of Evidence Based Birth was a comprehensive research review looking at outcomes of expectant management vs active management of low amniotic fluid in a healthy term pregnancy, as well as the reliability of the most common methods for assessing amniotic fluid volume.  Lots of great information to help women understand the risks and benefits and determine how they would like to proceed if they are faced with this decision at the end of their pregnancy.

 

 

#1 .  The Red/Purple Line: An Alternate Method For Assessing Cervical Dilation Using Visual Cues

marked purple lineThis post, written by Mindy Cockeram, LCCE is the most popular post ever published on Science & Sensibility.  Mindy reviewed and discussed the research on the the red/purple line that may be seen between the butt cheeks/natal cleft and the changes to this line as cervical dilation changes during labor.  This topic was simply fascinating to readers – and shared widely.  Professionals and consumers sent in pictures and discussed in the comments section their own observations.

 

Are you surprised by the top five posts on Science & Sensibility?  Do you have different favorites?  What else would you like to see covered in the future on this blog?  We welcome your input, your comments, suggestions and are interested in your favorite all time posts!  Share your thoughts and suggestions in our comments section below.

Childbirth Education, Healthy Birth Practices, Lamaze International, Science & Sensibility , , ,

Keynote Speakers Announced for 2014 Lamaze/DONA Confluence

February 14th, 2014 by avatar

confluence header

I was excited to hear that the keynote speakers for the Lamaze International/DONA International 2014 Confluence were announced yesterday.  I am very much looking forward to this conference and love the idea of Lamaze and DONA sharing energy, resources and learning opportunities.  I think that both organizations and all the men and women in attendance at the conference will benefit from this joint venture.  The conference takes place on September 18-21, 2014 in Kansas City, MO at the Kansas City Marriot Downtown.

Keynotes for this year’s event include:

Michele Deck, RN, BSN, MEd, LCCE, FACCE

deckAn internationally renowned presenter, author, and educator, Michele Deck is the co-founder, President, and Chief Executive Officer of G.A.M.E.S. and Tool Thyme for Trainers . She has won the prestigious “Excellence in Nursing” award, has been selected as a “Great 100 Nurses in Louisiana” and was elected to Sigma Theta Tau National Nursing Honor Society. In 2000, she received the sought-after Belinda Puetz award and in 2004 was the recipient of the Margaret L. Messore Lectureship award.  I have had the honor of bringing Michele to Seattle for a presentation given to our regional childbirth education conference and she brought down the house!  Her interactive and engaging activities left us all energized and excited.

Eugene R. Declercq, PhD

Eugene-Declercq2A professor of Community Health Sciences, assistant dean for DrPH Education at the Boston University School of Public Health and professor on the faculty of Obstetrics and Gynecology at the Boston University School of Medicine, Dr. Eugene R. Declercq has served as lead author of national reports on women’s experiences in childbirth. He was a technical advisor to the film documentary, The Business of Being Born, and developed and presented the short film, Birth by the Numbers. He is one of the Principal Investigators for the Massachusetts Outcomes Study of Assisted Reproductive Technologies (MOSART), a NIH funded study of infant and maternal outcomes associated with assisted reproductive technologies.  I have heard Dr. Declercq speak several times and always leave his presentations amazed at the skill he has in presenting data effectively and with humor.  I have great respect for his work and appreciate all he does to promote maternal infant health improvements.  Did you know that Dr. Declercq is a Lamaze Certified Childbirth Educator?

Katharine D. Wenstrom, MD

wenstrom_katharineDirector of the Division of Maternal-Fetal Medicine at Women & Infants Hospital of Rhode Island and director of the Prenatal Diagnosis Centers in Providence, RI, New Bedford, MA and Foxboro, MA. Katharine D. Wenstrom is also professor of obstetrics and gynecology at the Warren Alpert Medical School of Brown University. A geneticist and nationally recognized leader in the field of maternal-fetal medicine, Dr. Wenstrom works to set the standard for the best care of high-risk pregnant women.  What a unique perspective this perinatologist must have.  I look forward to hearing her speak and sharing her views on pregnancy and birth.

Ngozi Tibbs, CD(DONA), LCCE, IBCLC

ngozi tibbsThe founder and owner of Sankofa Childbirth Education and Lactation Services, in Pittsburgh, PA, Ngozi Tibbs holds a Bachelor’s Degree in Maternal Child Health and is a candidate for a Master of Public Health in – 2014. She has served as a doula, childbirth educator and lactation consultant primarily serving at risk communities including: African American, Latino, immigrant and low- income women from more than 10 counties in the United States. She is a Certified Birth Doula through DONA International, a Certified Childbirth Educator (LCCE) through Lamaze International, an International Board Certified Lactation Consultant (IBCLC) and a La Leche League Leader through La Leche League International.  What a powerful combination of talents!  I am confident that Ngozi will share information that will help everyone to better meet the needs of underserved populations who are often lacking in birth services promoting safe and healthy birth.

Penny Simkin, PT

penny_simkinA physical therapist who has specialized in childbirth education and labor support since 1968, Penny Simkin has prepared over 11,000 women, couples and siblings for childbirth. She has produced several birth-related films and is the author of many books and articles on birth for parents and professionals. Currently, she serves on several boards of consultants and on the senior faculty at the Simkin Center for Allied Birth Vocations at Bastyr University, which was named in her honor.  Penny has such wisdom and experience in helping families to have a better birth experience, and her work has had such an impact on birth professionals and families all around the world.  As one of the founding members of DONA International, it is very fitting that she is speaking at this joint conference.

This conference will be very rich in experience and expertise and I am definitely planning on attending. It is also a great way to meet my continuing education requirements.  I am looking forward to hearing who will be presenting concurrent sessions, finding out what preconference sessions are scheduled and making plans to connect with colleagues from all over the world.  Is your calendar marked for this conference?  Registration opens April 15th, 2014!  Register early to take advantage of early bird prices, once it opens.  To learn more about the conference and stay up to date on important information, check back to the conference site regularly.

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