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Congratulations to Cara Terreri and Lamaze Parent Blog – Giving Birth With Confidence

June 23rd, 2015 by avatar

Congratulations Giving Birth withWhile Science & Sensibility is geared primarily for birth professionals and health care providers, Lamaze International also has a long running blog that is written by Cara Terreri, specifically with the expectant family in mind.  Giving Birth with Confidence (GBWC) offers families a wonderful mix of posts that highlight current best practice and evidence based information, fun and lighthearted topics for the pregnant and parenting crowd, and regular pregnancy week by week features that showcase development and concerns as a people move through their pregnancies.  One of my favorite topics on the GBWC blog is the “Great Expectations” series which follows a pregnant person through their pregnancy and birth, with regular posts documenting the progress, emotions and circumstances that are arising for the featured family.

I am not the only one that thinks that the Giving Birth with Confidence Blog is the bomb!  Healthline recently named Giving Birth with Confidence one of the top pregnancy blogs for 2015.  Cara Terreri has been writing the GBWC blog since its inception, and the honor is well deserved.  You may recall Cara from some posts she has done on this blog, as we followed her on her path to becoming a Lamaze Certified Childbirth Educator.  She has also been a guest blogger here on other topics.

I asked Cara some questions about her experience as writer and community manager for the Giving Birth with Confidence Blog and share her answers with you here now.

Sharon Muza: What do you hope that parents take away from reading the Giving Birth with Confidence blog?

Cara Terreri: I hope that parents  take away from GBWC that birth is a normal part of life, not an illness or fearful event, and in fact, that it can be an exhilarating, amazing, and beautiful experience. I also hope they take away practical information to help prepare for and shape their experience.

SM: What are some of the challenges that you see when writing a blog geared for parents in the childbearing year?

CT: I can identify two challenges — giving topics the detail they deserve without overwhelming parents with information. That’s a challenge childbirth educators often face in classes, too. The other is presenting information in a non-biased, non-judgmental way. It can be easy for my opinion to creep in when I should be presenting “just the facts, ma’am.”

SM: There has never been more online information available to parents – what distinguishes GBWC from other online resources?

CT: Evidence based information, first and foremost. Followed by a tendency to address important issues and choices women face, not just what’s “hot” or “trendy.”

SM: What have been some of your favorite posts of all time?  What about the favorite posts of the readers?

CT: My favorite posts come from the expectant moms who participate in our Great Expectations series, an every-other-week chronicle of their pregnancy. Often, the posts just contain thoughts and reflections of pregnancy, motherhood, and birth, which is just perfect. Our readers, interesting enough, tend to click through most to our post about Lamaze breathing, which provides clarity on how Lamaze teaches breathing as a coping mechanism in labor. Families might come to us to learn about breathing, but they leave with so much more!

SM: Why should childbirth educators and other birth professionals share this blog with the families that they work with and encourage them to become regular readers?

CT: Birth professionals and CBEs can trust the content, when they recommend it to the families they work with. It supports and mirrors what is taught in a Lamaze class. Our content is also easy to read and understand.

I hope that you will share this blog with the families you teach or work with, so that they can receive the information and community that GBWC offers to readers.  If you have suggestions for future post topics, would like to be a guest blogger or have some helpful feedback, please contact Cara directly.

cara headshotI would like to invite all of you to join me in congratulating my friend and colleague Cara Terreri and the Giving Birth with Confidence blog on a job well done!  I know that many families are better prepared and better informed as a result of the exceptional information that is shared on the blog.  Make sure that the families that you work with are aware of this valuable resource.  This recognition is well-deserved and I am delighted that you have received it.  I look forward to more posts on the topics that are important to families everywhere.

Awards, Babies, Giving Birth with Confidence, Lamaze International, Lamaze News , , ,

Lamaze International Launches Free Pregnancy to Parenting Mobile App to Support Families

June 8th, 2015 by avatar

Free new app!Lamaze International is delighted to announce the launch of their new “Pregnancy to Parenting” mobile app for families.  This just released app is meant to be a comprehensive evidence based resource for people to use during the childbearing year and is free to anyone who downloads it.  In addition to sharing customized information about their pregnancies, the app also provides tips and information for labor and birth and then continues to support families after birth as they feed and care for their new baby.  85% of millennials are heavily reliant on their smartphones for both information as well as entertainment throughout the day.  Lamaze International, well-recognized as the leader in childbirth education, meets today’s parents where they are at (on their smart phones) with this well designed, well thought-out app that takes families from conception all the way into their first weeks and months of parenting!

After downloading the app from either the Apple App store or from Google Play, parents can get weekly information about their pregnancy, updates on what baby development looks like that week and even access fun lighthearted facts that are entertaining as well as interesting. Daily tips, relevant articles, and Q&As are also included.

The “Pregnancy to Parenting” app lets pregnant families find a Lamaze class near them (make sure your information is up to date in your membership profile!  We will discuss how to access and update your profile in a post here on Thursday), maintain a calendar that tracks their CBE classes, doctor or midwife appointments, and even create a pregnancy journal with notes, videos and pictures.LI_MobileAppScreenshots5

As labor begins, there is a handy contraction timer and parents can access evidence based information about what to expect during labor and birth as well as useful tips, for example – information on the importance of moving around and changing positions as labor continues to progress.

After birth, parents can use the useful breastfeeding and diaper tracker as they head into the wonderful but exhausting first days and weeks with their newborn.  There is also information on postpartum mood and anxiety disorders, what to look for and how to get help.

The content in the “Pregnancy to Parenting” mobile app was prepared and approved by Lamaze Certified Childbirth Educators just like you, and delivered in a thorough and easy to navigate app that looks great and functions well on today’s mobile devices.

As the “Pregnancy to Parenting” mobile app gets introduced to expectant and new parents, Lamaze International is offering educators and other birth professionals an opportunity to participate in a 60 minute webinar: Utilizing the New Lamaze Mobile App – Pregnancy to Parenting, facilitated by former Lamaze President Michelle Deck, RN, MEd, BSN, LCCE, FACCE on Tuesday, June 9th at 1:00 PM EDT.  The purpose of this webinar is to share information with childbirth educators on the app’s content and functionality as well as suggest how educators can introduce the mobile app to families and incorporate the app in their classrooms.  You can register now for this informative session.

LI_MobileAppScreenshots3Lamaze International has prepared an educator resource kit to help you spread the word about the new “Pregnancy to Parenting” mobile app that includes flyers for your classroom and workplace, a friendly email that you can use to introduce the app to your students and community and even PowerPoint slides that can be integrated into your classroom curriculum.  Learn more about the mobile app and these resources here on the resource kit page of the Lamaze International website.

Lamaze International wants to offer the families you work with (and all families) access to additional information that supports what they are already learning in their Lamaze class.  Having access to resources that provide evidence based information in a format that today’s families are used to accessing helps families to have a safe and healthy birth and make decisions that support healthy mothers, healthy babies and healthy families.  Making it easy for families to find a Lamaze class in their area, when they have not yet signed up for childbirth classes, helps educators to reach more families and benefits educators by directing those families right to you! The new “Pregnancy to Parenting” mobile app is a great tool for families and educators a like.  Head over to the app store of your choice and download the app, so you can become familiar with it and will be ready to share with the families that you work with.  See you in the webinar!

Babies, Breastfeeding, Childbirth Education, Lamaze International, Lamaze News, News about Pregnancy, Pregnancy to Parenting Mobile App , , , ,

Book Review: “A Breastfeeding-Friendly Approach to Postpartum Depression: A Resource Guide for Health Care Providers”

May 28th, 2015 by avatar

By Cynthia Good Mojab, MS, LMHCA, IBCLC, RLC, CATSM

monograph cover_tn_kenKathleen Kendall-Tackett, Ph.D, author, IBCLC, researcher, internationally acclaimed speaker and occasional contributor to our blog, has written a new book – “A Breastfeeding-Friendly Approach to Postpartum Depression: A Resource Guide for Health Care Providers,” that tries to lay to rest the myth that receiving help for a postpartum mood disorder and breastfeeding are not compatible.  I asked Cynthia Good Mojab to share her expert review of the book to commemorate the end of Perinatal Mood Disorders Awareness Month.  Cynthia is the perfect person for this task as she wears the hat of both a lactation consultant and a clinical counselor.  As birth professionals who work with families throughout the childbearing year, we have a sincere responsibility to provide information and screening resources so that families can be evaluated and directed to receive help that continues to support the breastfeeding dyad if breastfeeding is the parent’s desire.  Read Cynthia’s review and consider what you can do to increase awareness of perinatal mood disorders and offer your clients and students the best evidence based information available about how treatment options and breastfeeding are not mutually exclusive. – Sharon Muza, Community Manager, Science & Sensibility

Globally, the prevalence of postpartum depression is as high as 82.1% when measured using self-report questionnaires and as high as 26.3% when measured using structured clinical interviews (Norhayati, Nik Hazlina, Asrenee, & Wan Emilin, 2014). These high rates mean that a significant proportion of families navigate breastfeeding in the context of postpartum depression.

As a perinatal mental health care provider and an IBCLC, I am frequently contacted by parents who found me after having been unable to access breastfeeding-compatible mental health care for postpartum depression (Good Mojab, 2014). They report feeling as though they are caught between a rock and a hard place: they’ve been diagnosed with postpartum depression and have been told by their primary care provider and/or their mental health care provider that they must wean in order to treat their depression. Sometimes they are even told that breastfeeding is causing their depression. Not only is that not true, but the relationship between infant feeding and postpartum depression is actually quite complex (Nonacs, 2014). While breastfeeding problems increase the risk of postpartum depression, breastfeeding itself is protective (Kendall-Tacket, n.d.). And research shows that infant-feeding intentions matter: breastfeeding mothers who are unable to accomplish their breastfeeding goals are two-and-a-half times more likely to develop postpartum depression (Borra et al., 2015). These research findings match what I see in my private practice: the partial or complete loss of a parent’s desired experience of breastfeeding can precipitate deep grief and worsen or precede the onset of postpartum depression.

Fortunately, there are many breastfeeding-compatible treatments for postpartum depression which health care providers and mental health care providers can use to effectively treat the vast majority of their clients. Dr. Kathleen Kendall-Tackett’s new book, “A Breastfeeding-Friendly Approach to Postpartum Depression: A Resource Guide for Health Care Providers,” presents an up-to-date overview of the related research in an outline format that is quick and easy to read. She presents a compelling case for ensuring that families coping with breastfeeding problems receive additional lactation support and that breastfeeding parents coping with postpartum depression have access to treatment that is compatible with the continuation of breastfeeding.

In the first chapter, Kendall-Tackett introduces the rationale for screening for, referring for, and treating postpartum depression: postpartum depression is common in new parents and untreated postpartum depression has significant, immediate, and long-term negative consequences for both parent and child. She then presents research showing that breastfeeding does not cause depression (as some health care providers falsely believe); rather, breastfeeding serves to protect the dyad from the deleterious consequences of postpartum depression via its dampening of the stress response and via its facilitation of ongoing engagement between parent and baby. (When we shift our culturally based reference frame in recognition that breastfeeding is the biological norm for humans, we can see that this research also shows that formula feeding increases the risk of deleterious consequences from postpartum depression through increasing the stress response and potentially lessening ongoing engagement between parent and baby.) The substantial evidence base for why the effective treatment of postpartum depression is so critical—briefly introduced in chapter 1—is presented in more detail in chapter 3. Psychological disorders that often co-occur with postpartum depression, such as posttraumatic stress disorder, bipolar disorder, eating disorders, and obsessive-compulsive disorder, are then described. Chapter 5 reviews the complex causes of postpartum depression, including inflammation, fatigue and sleep disturbance, pain, traumatic birth experiences, infant characteristics such as illness and prematurity, and maternal characteristics, life history, psychiatric history, and social context.baby breastfeeding

Chapter 6 emphasizes the importance of screening for postpartum depression. Kendall-Tackett wisely advocates that validated screening tools be used (rather than relying merely on casual observation) and that screening occur in a variety of care settings—prenatal, hospital, home, and pediatric office visits. The recommendation for prenatal screening is very important. Depression during pregnancy is common (11% to 23% of pregnant women experience depression), is a risk factor for adverse reproductive outcomes such as preterm delivery, and is among the strongest predictors of postpartum depression (Gaynes, et al., 2005; Yonkers, et al., 2009; Norhayati, Nik Hazlina, Asrenee, & Wan Emilin, 2014). Kendall-Tackett describes three reliable screening tools—two of which (the Patient Health Questionnaire-2 and the Edinburgh Postnatal Depression Scale) are in the public domain. This excellent chapter would be improved further with information about how to implement perinatal mental health screening in various settings, including the need to build a breastfeeding-friendly referral network prior to initiating screening and the need to develop or obtain materials (e.g., brochures, handouts, posters, resource lists, referral lists) that provide anticipatory guidance and help parents more easily access information, support, and treatment for postpartum depression (Good Mojab, 2015).

In chapter 7, Kendall-Tackett presents the development of a breastfeeding-friendly treatment plan as being grounded in the facilitation of informed decision making—something perinatal care providers are ethically obligated to do. Informed decision making requires that parents be offered evidence-based information that will allow them to weigh the risks and benefits of a variety of treatment options. This final chapter presents such information in the form of a succinct review of the available research on treatments that have been shown to be effective in treating depression, including: 1) “alternative” treatments (i.e., long-chain omega-3 fatty acids, exercise, S-Adenosyl-L-Methionine, and bright light therapy), 2) psychotherapeutic treatments (i.e., cognitive behavioral therapy and interpersonal therapy), 3) herbal medications (i.e., St. John’s Wort); and 4) anti-depressant medications. The reader is referred to the Infant Risk Center for up-to-date information about the use of particular anti-depressant medications during breastfeeding. Additionally, Medications and Mothers’ Milk: A Manual of Lactational Pharmacology is listed among the references. The LactMed app, though not mentioned in the book, is another useful resource for facilitating informed decision making regarding the use of drugs and supplements during breastfeeding.

The appendices are helpful for readers who have not yet begun to screen for perinatal depression and are looking for appropriate screening tools. Included are the Postpartum Depression Predictors Inventory—which can be used to identify risk factors for postpartum depression—and the Edinburgh Postnatal Depression Scale—which is well-validated as a screening tool for perinatal depression in mothers, in many cultures and languages, and in fathers. (A gender/prenatal/postpartum inclusive version of the EPDS is available here.) Because postpartum depression often includes symptoms of anxiety and/or co-occurs with an anxiety disorder, the appendices would have been improved by including the well-validated Generalized Anxiety Disorder 7-item (GAD-7) Scale, which is also in the public domain.

Scattered throughout the book are links to video clips that provide information on topics such as how breastfeeding protects maternal mental health and how breastfeeding ameliorates the negative effects of sexual assault. Readers with an auditory learning style will especially appreciate this access to online interviews and mini-presentations. Unfortunately, the dark gray links on a light gray background can sometimes be hard to read, leaving the reader to wonder “is that character a capital I, a lowercase L, or a numeric 1?” But, the video resources are worth the trial and error needed to open a couple of the links. Those with access to a smartphone with a QR code reader or barcode scanner can simply scan the code for each video clip to open the links, which greatly simplifies the process.

While the title of the book, “A Breastfeeding-Friendly Approach to Postpartum Depression,” is gender neutral, readers should know that the book is focused on cisgender mothers and uses cisnormative language. Certainly, there is a dearth of research on transgender and gender non-conforming parents which makes it difficult to write an evidence-based book addressing their needs in the context of breastfeeding/chestfeeding and postpartum depression. Nonetheless, we can infer that the high rate of clinical depression (44.1%) among transgender individuals means that transgender parents are at high risk for postpartum depression. And, the fact that transgender individuals experience “gender insensitivity, displays of discomfort, denied services, substandard care, verbal abuse, and forced care” in health care settings (Bockting, et al., 2013) means that transgender parents are also at high risk of being unable to access effective mental health care, much less breastfeeding/chestfeeding-compatible mental health care. Perinatal care providers need to be aware of these higher risks and learn how to bring their services into compliance with the Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People (Bockting, et al., 2011). The lactation-friendly treatment options for postpartum depression that are reviewed in the book are likely to also be effective for transgender and gender non-conforming parents who breastfeed, chestfeed, or feed their expressed milk to their babies. The effective treatment of breastfeeding/chestfeeding parents with postpartum depression will also need to include responding to whether and how they are experiencing gender dysphoria during lactation.

Although written for health care providers, “A Breastfeeding-Friendly Approach to Postpartum Depression” will also be useful for childbirth educators, doulas, lay supporters, lactation specialists, and perinatal mental health care providers as they strive to do their part to offer families evidence-based anticipatory guidance about postpartum depression and its treatment options, advocate for more lactation support for families coping with breastfeeding difficulties, screen for postpartum depression, refer to and effectively collaborate with other breastfeeding-friendly perinatal care providers, and provide services that avoid iatrogenically increasing the risk of negative health, developmental, and mental health consequences for parents and babies through the unnecessary undermining of breastfeeding. The more widely Dr. Kendall-Tackett’s powerful little book is read and applied in practice, the more breastfeeding families will have access to breastfeeding-compatible treatment that truly meets their needs in the context of postpartum depression.

References

Bockting, W., Miner, M., Swinburne, R., Hamilton, A., and Coleman, E. (2013). Stigma, mental health, and resilience in an online sample of the US transgender population. Am J Public Health, 103:943–951. Accessed: May 23, 2015. Url: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698807/pdf/AJPH.2013.301241.pdf

Borra, C., Iacovou, M., and Sevilla, A. (2015). New evidence on breastfeeding and postpartum depression: The importance of understanding women’s intentions. Maternal and Child Health Journal, 19:897–907. Url: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4353856/pdf/10995_2014_Article_1591.pdf

Coleman, E., Bockting, W., Botzer, M., et al. (2011). Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. International Journal of Transgenderism, 13:165–232. Accessed May 23, 2015. Url: http://www.wpath.org/uploaded_files/140/files/IJT%20soc,%20v7.pdf

Gaynes, B., Gavin, N., Meltzer-Brody, S., Lohr, K., Swinson, T., Gartlehner, G., Brody, S., Miller, W., et al. (2005). Perinatal depression: Prevalence, screening accuracy and screening outcomes;Evid Rep Technol Assess (Summ). 119:1–8.

Good Mojab, C. (2014). Mental Health Care for Postpartum Depression During Breastfeeding. Lynnwood, WA: LifeCircle Counseling and Consulting, LLC. Accessed May 23, 2015. Url: http://lifecirclecc.com/yahoo_site_admin/assets/docs/MentalHealthCarePPDBfd2014.pdf

Good Mojab, C. (2015). The Basics of Perinatal Screening. Accessed May 23, 2015. Url: http://www.lifecirclecc.com/professionals/perinatal_screening

Hale, T. and Rowe, H. (2014). Medications and Mothers’ Milk: A Manual of Lactational Pharmacology. Amarillo, TX: Hale Publishing.

Kendall-Tackett, K. (n.d). Why Breastfeeding and Omega-3s Help Prevent Depression in Pregnant and Postpartum Women. Accessed May 23, 2015. Url: http://www.uppitysciencechick.com/why_bfand_omega_3s.pdf

Kosenko, K., Rintamaki, L., Raney, S., and Maness, K. (2013). Transgender patient perceptions of stigma in health care contexts. Med Care, 51(9):819-22.

Nonacs, R. (2014). Breastfeeding and Postpartum Depression: Further Insights Into a Complicated Relationship. Massachusetts General Hospital Center for Women’s Mental Health. Accessed: May 23, 2015. Url: http://womensmentalhealth.org/posts/breastfeeding-postpartum-depression-insights-complicated-relationship/

Norhayati, M., Nik Hazlina, N., Asrenee, A., & Wan Emilin, W. (2014). Magnitude and risk factors for postpartum symptoms: A literature review. Journal of Affective Disorders, 175C, 34-52.

Yonkers, K. Wisner, K., Stewart, D. Oberlander, T., Dell, D., Stotland, N., Ramin, S., et al. (2009). The management of depression during pregnancy: A report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists. Obstet Gynecol. 114(3):703–713. Accessed: May 28, 2015. Url: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3094693/pdf/nihms293837.pdf 

About Cynthia Good Mojab

cynthia good mojab headshot 2015Cynthia Good Mojab, MS Clinical Psychology, is a Clinical Counselor, International Board Certified Lactation Consultant, author, award-winning researcher, and internationally recognized speaker. She is the Director of LifeCircle Counseling and Consulting, LLC where she specializes in providing perinatal mental health care, including breastfeeding-compatible treatment for postpartum depression. Cynthia is Certified in Acute Traumatic Stress Management and is a member of the American Academy of Experts in Traumatic Stress and the National Center for Crisis Management. Her areas of focus include perinatal loss, grief, depression, anxiety, and trauma; lactational psychology; cultural competence; and social justice. She has authored, contributed to, and provided editorial review of numerous publications. Cynthia can be reached through her website.

 

Babies, Book Reviews, Breastfeeding, Childbirth Education, Evidence Based Medicine, Guest Posts, Maternal Mental Health, New Research, Newborns, Perinatal Mood Disorders, Postpartum Depression, Uncategorized , , , , , , , ,

Elisabeth Bing, Mother of Lamaze, Remembered for Humanizing Childbirth

May 18th, 2015 by avatar

“I hope I have made women aware that they have choices, they can get to know their body and trust their body.”

 

Elisabeth Bing, 1914-2015, Co-Founder of Lamaze International

elisabethbingElisabeth Bing, known as the “mother of Lamaze” passed away on Friday, May 15th, 2015 in her home in New York City, NY a few weeks shy of her 101st  birthday.  Elisabeth, along with Marjorie Karmel, founded Lamaze International (then known as The American Society for Psychoprophylaxis in Obstetrics/Lamaze, or ASPO/Lamaze) 55 years ago.  Her legacy lives on, not only in the numerous books she authored, (Six Practical Lessons for an Easier Childbirth, her most well known book, first published in 1967) but in each one of us, especially Lamaze Certified Childbirth Educators, who have been helping women and families for decades to be “aware that they have choices, they can get to know their body and trust their body.”

There are many resources (see links below) written that document Elisabeth’s life, her journey from Germany, to England and then finally the USA, where she established a groundbreaking childbirth education program at Mt. Sinai Hospital in Manhattan.  I didn’t want to rewrite what has already been documented.  I encourage you to read them as they are both fascinating and factual, documenting the magnificent achievements of a life committed to improving birth for women and babies.

Teaching in Studio, 1978 © Lamaze

 

I wanted to share information about Elisabeth that has not already been shared. I never had the honor of meeting Elisabeth Bing, nor hearing her speak, so I wanted to ask some of the women and leaders of Lamaze International to share what Elisabeth was like from their own personal experiences with this icon of childbirth education. I wanted to know how she influenced their lives and their careers, and to learn more about who she was and what she was like.  I also wanted to share this information with you.  Please join me in, as these women share their thoughts and memories.

Judith Lothian, PhD, RN, LCCE, FACCE, Chairperson of the Lamaze Certification Council Governing Body, Associate Editor of the Journal of Perinatal Education and co-author of The Official Lamaze Guide: Giving Birth with Confidence

Mary Jo Podgurski, RNC, EdD, LCCE, FACCE, Past President of Lamaze International

Robin Elise Weiss, PhD, MPH, LCCE, FACCE, author and current Lamaze International President

Linda Harmon, MPH, Executive Director of Lamaze International

Sharon Muza: Do you remember the first time you met Elisabeth? Can you share the details of that meeting and your first impressions?

Linda Harmon: I met Elisabeth for the first time at the annual conference over twenty years ago. I was meeting the “mother of Lamaze”. She was gracious and warm, and took the time and interest to get to know me personally. It was always special to have a few moments with Elisabeth at the conference for many years after our first meeting all those years ago.

© Librado Romero/The New York Times

© Librado Romero/The New York Times

Robin Elise Weiss: The first time I actually saw Elisabeth in person was at a conference in Chicago. I was coming down the escalator and I looked over at the fountain and she caught my eye. She was sitting there with Sheila Kitzinger, and all I could think was “Wow what an amazing woman. And two great legends sitting together just as simple as could be, not even understanding the impact that they’ve had on my life.

Mary Jo Podgurski: I’d always admired Elisabeth from afar, hanging onto her every word during her talks and taking an occasional picture with her at a conference. I clearly recall when we first spent time together. I was elected to the Lamaze board in 1994. Elisabeth asked me to meet with her. She engaged me in conversation about so many things – my passion for working with teens, my personal belief system, my family, my values, my experiences with birthing women, my own births – I realized I was being vetted. She was wise, she listened to hear, and she was visionary. She became my mentor. In time we became close personal friends.

Judith Lothian: I met Elisabeth in 1973. She interviewed me in her apartment…where she died…for the NYC Lamaze teacher training program. I was nervous. She was gracious and kind. I took the seminar later that year. In that same apartment. A group of about 8. It was wonderful. Take aways? They were the foundation for my career and life as a childbirth educator. “The breathing works because women make it their own in labor” There was nothing rigid about the way she taught the principles of the then “psychoprophylaxis”. And then began a 20 year journey where Elisabeth mentored me…she had me take over the teacher training program in NYC and then said “It’s time you went on to DC to the national organization”. I never would have done either without her literally telling me to do it. A wonderful mentor.

Dr. Marshall Klauss, Elisabeth Bing, Linda Harmon (L-R)

Dr. Marshall Klauss, Elisabeth Bing, Linda Harmon (L-R) 1996 © Lamaze

SM: When did you last meet/see/communicate with Elisabeth? Can you share those details?

JL: We did a video for the 50th anniversary of Lamaze. I spent a day with Elisabeth in her apartment. We shared memories and had tea together and she watched the taping and participated. It was an incredible day.

REW: One of the last times that I saw Elizabeth she was actually swimming in the ocean at the Fort Lauderdale Lamaze conference. All I could think was I hope I have that much spunk when I’m 90 years old.

LH: I remember visiting Elisabeth in her New York apartment when Lamaze had the opportunity to do a quick Lamaze lesson on the Regis and Kelly show. I got the grand tour which included her ground floor studio where she taught Lamaze classes for many years.

MJP: The last time we saw one another was her 100th birthday celebration in her apartment in NYC – July 8th, 2014. We last spoke at Christmas, 2014, when I sent her my usual present, a dozen red roses. She never failed to call and thank me, and then she always sent a thank you note. I treasure her notes. When I was in New York I always went to see her. I remember walking into her apartment about two years ago. When I entered, she looked up and said, “It’s my friend Mary Jo!”

Elisabeth with son Peter © Lamaze

Elisabeth with son Peter © Lamaze

SM: How would you describe Elisabeth’s personality and character?

MJP: Independent. Wise. Fiercely loyal. Kind. Intellectual. Curious. Gentle. Visionary. Strong-willed.

REW: I saw her as an amazing combination of feisty and sweet. She wouldn’t take no for an answer but you always left with a positive impression. She always made me feel like I was the only person she was talking to or cared about in the moment.

JL: Strong. Wise. Generous and kind.

SM: How do you think Elisabeth would want to be remembered?

LH: For starting what was at the time a radical consumer movement to improve birth for women and their partners, a legacy that has stood the test of time and continues to be relevant and important 55 years later.

MJP: As an advocate for birth and for women. As a musician and writer. As a mother. As a friend

JL: As someone who helped women give birth easily and simply.

SM: Of all the contributions Elisabeth has made to childbirth, both here in the USA, and abroad, what do you think is her greatest legacy?

MJP: Elisabeth modeled independence, strength and true advocacy. She empowered women. We (CBEs) are her legacy.

JL: Beginning, really, the movement to change birth in the US. She was at the forefront and gave women with her “Six Practical Lessons” a way to do it. Simply and easily. It may seem rigid and simplistic today but it worked then.

REW: Her greatest legacy will be the fact that women now have choices that were once not even considered possible. Many women do not know her name, but have her to thank for the options that they now have in childbirth.

SM: What advice would Elisabeth give to today’s pregnant person about their upcoming labor and birth?

MJP: One of the last things I remember her saying at a conference presentation was ‘Now, let’s take on the insurance companies’. I think Elisabeth would empower a pregnant person by sharing knowledge, speaking truth to power, and modeling courage. I think she’d say that the woman’s body knew how to give birth.

REW: Know your options. Fight for what works for you and your family.

SM: Do you have a favorite quote or story that Elisabeth said or shared with you and others? What might that be?

JL: Elisabeth in the 1970s was on a radio show with Dr. Bradley. She refused to talk about which “method” of childbirth was better. She said “Anything that helps women have good births is what is important”. I was impressed that she was not pushing Lamaze… but acknowledging women. She was gracious and kind always.

MJP: Once when we were discussing her youth in Germany and her time in England during the Blitz, she told me how she reacted to the bombings. She said that, at first, she went to the shelters with other people when the air raid sirens wailed. In time, she decided not to go. She said she wouldn’t die huddled below ground, but would continue doing whatever she was doing when the raid began. Those words resonated with me then, and echo for me now.  I visited her about six weeks after 9/11. She was calm and unafraid. I spoke with her as soon after the attacks as I could; she expressed no anxiety. Elisabeth showed me how to live with courage and well.

SM: Any other comments that you would like to share?

MJP: I loved Elisabeth Bing as a mentor, a true educator, a strong woman of integrity, but most of all, as my dear friend. I will always love and remember her.

Dr. Mary Jo Podgurski and  Elisabeth Bing 2014 © Podgurski

Dr. Mary Jo Podgurski and Elisabeth Bing 2014 © Podgurski

JL: I found Lamaze (ASPO) because I wanted a natural birth. But then I found Elisabeth when I wanted to teach classes and help women have the wonderful birth experience that I had. I had the privilege of being trained by her…and, contrary to all that is said about early Lamaze, there was nothing rigid about the what she taught or the way she taught. What I learned from Elisabeth was the foundation for all that I have done as a childbirth educator and nursing educator, and as an advocate for safe, health birth.. I am eternally grateful.

_____________________

Elisabeth Bing had a vision that there was a better way to give birth and she made that vision a reality through her books, the organization she founded (Lamaze International), the thousands upon thousands of families she taught, the relationships she forged with medical professionals, and the men and women she mentored, guided, supported and taught who have gone on to become childbirth educators themselves, carrying on the mission and vision. Elisabeth once said, “I hope I have made women aware that they have choices, they can get to know their body and trust their body.” I think, upon reflection, that we can all agree that Elisabeth Bing was beyond successful in this goal, and millions of families are grateful for her work and her effort.  I join Lamaze International and the Lamaze leaders, past and present, Lamaze Board of Directors and Staff, Lamaze Certified Childbirth Educators, readers of this blog and families everywhere in sending our deepest sympathies to Elisabeth’s family on the loss of their mother and family member.  We will forever be deeply indebted to her legacy.

Do you have memories of meeting Elisabeth Bing? Hearing her speak? Reading her books?  Please take a moment to share your thoughts and what her work meant to you in our comments section.  Thank you.

Books authored by Elisabeth Bing (incomplete list)

 

Babies, Childbirth Education, Journal of Perinatal Education, Lamaze International, Lamaze Method, Lamaze News , , , , , ,

Book Review: Birth Ambassadors; Doulas and the Re-Emergence of Woman-Supported Birth in America.

May 7th, 2015 by avatar

By Kim James, BA, BDT(DONA), CD(PALS), ICCE, LCCE

May is International Doula Month and Lamaze International recognizes the importance of labor support. (Note – there are both birth and postpartum doulas who work with families during the childbearing year. We are grateful for the work that they both do.)  In fact, our third Healthy Birth Practice specifically addresses doulas and support people as an effective component of safe and healthy birth. The American College of Obstetricians and Gynecologists (ACOG) in their 2014 Safe Prevention of the Primary Cesarean Obstetric Care Consensus Statement stated “published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula.”  Childbirth educators and health care providers have ample opportunity to inform parents about the benefits of a doula when they are meeting with families and patients.  

In mid-2014, sociologist Christine Morton, Ph.D. with Elayne G. Clift, MA, wrote a book, Birth Ambassadors: Doulas and the Re-Emergence of Woman-Supported Birth in America examining doulas from both an historical perspective as well as an assessment of the role of the doula in current American society . Kim James, LCCE and certified DONA birth doula, reviews this book and shares her perspective and take-aways with readers of this blog.

This book would make a great read for a book club book for birth professionals, and Kim generously shares some discussion questions at the end of today’s post to facilitate your discussion, should you wish to participate.  Alternately, if you have read the book, please feel free to respond in our comments section. 

Science & Sensibility and Lamaze International want to thank all the doulas who work tirelessly to support families as they birth their babies and transition to parenthood. Happy International Doula Month. – Sharon Muza, Science & Sensibility Community Manager. 

idm15 lamazeBirth Ambassadors: Doulas and the Re-Emergence of Woman-Supported Birth in America, written by Christine Morton, Ph.D. with Elayne G. Clift, MAis a thorough and compelling documentary of the history of doula support, the current dilemmas and issues facing the doula occupation, what drives doulas to pursue this work and how the work of doula support might fit into the future as the United States strains to find better ways of providing quality improvements in maternity care. For doula trainers and doulas looking to pursue this work in a professional manner, Birth Ambassadors is critical, mandatory reading. (For trainers and doulas interested in how to use this book to critically assess your work, please see the discussion questions below this article).

But what about for childbirth educators? What in it for them?

While the history is fascinating, it’s the critical sociological analysis of the current dilemmas and issues facing the doula occupation that childbirth educators’ need to thoroughly understand, especially Lamaze certified childbirth educators.

Lamaze International’s third Healthy Care Practice, ‘Bring a Loved One, Friend or Doula for Continuous Support’, outlines why continuous support is important and how a doula performs their work:

  • Continuous support can help alleviate fear and worry.
  • A doula’s intuitive sense and training mean emotional and physical needs are met with timely, individualized care.
  • Greater emotional and physical comfort may encourage the most efficient and healthy labor progress.

While most childbirth educators are aware of the intended benefits of doula care, not all are aware of the dilemmas doulas face in performing their work and the institutional and cultural issues that prevent doulas from having the greatest beneficial impact. Lamaze certified childbirth educators must have a firm understanding of these dilemmas so as not to ‘over-promise’ what the third Lamaze Healthy Care Practice is intended to deliver.

I want to highlight three dilemmas facing doulas that childbirth educators should be aware of and what they can do to educate parents who want doula-supported birth experiences:

Kim James' well read Birth  Ambassadors

Kim James’ well read Birth Ambassadors

First dilemma

The ecological fallacy of applying aggregate results of research that show doula efficacy to an individual family’s outcome. The cultural and institutional context of most US hospital births limit the doula’s efficacy, often by prohibiting truly continuous support and refusing to recognize a doula’s unique scope of practice. Childbirth educators should lead discussions with parents about what hospitals and which care providers in their areas are most and least supportive of doula care. Childbirth educators are instrumental in helping parents understand the questions they can ask during hospital tours and prenatal visits to find out if their chosen place of birth and attendant understand and support doulas attending families at births.

Second dilemma

The frequent contradiction between a doula’s personal values (often a deep belief in the optimality of the midwifery model of care, natural, drug-free childbirth or specific parenting practices) and her obligation to provide unconditional support for parents’ birth and parenting choices. Childbirth educators must help parents clarify their values around birth and parenting so that parents can find the support people who suit them best. Not every doula will be the best support for every parent.

Third dilemma

No occupation-wide standard for training or certification. The competing tensions within doula organizations between increased professionalization and maintaining low barriers to entry for all people to become doulas remain unresolved. While the majority of doulas are well-trained through recognized, long-standing organizations, some will only have received light, if any, training possibly through correspondence and online courses. Not every doula’s skill set is the same. Not every doula will practice within a scope of practice that is evidence based. Not every doula will pledge to follow a recognized code of ethics backed by an organization with an active grievance policy. Childbirth educators who make referrals to families asking for doulas should always make referrals to doulas who are well-trained, consistently receive excellent feedback from the families they serve and most importantly practice in a manner that is consistent with the evidence based third Lamaze Healthy Care Practice.

As a current Lamaze certified childbirth educator and professionally-working certified doula, I found my own experiences reflected in this book. While at times uncomfortable to confront the dilemmas and issues our occupation faces, Birth Ambassadors is well worth reading for the history and reflections for the future. It will give childbirth educators who are not currently practicing doulas good data on what the real impact of doula support means for the families that hire them.

Book club discussion questions

When Birth Ambassadors was newly released, I hosted a book club-style discussion group with several local doulas to discuss this book’s implications for our current and future work. Here are the big questions that came up for our group representing doulas who were well-established in their practices, those who were just starting out and both certified and non-certified doulas.

  • When is your personal bias stronger than your ability to offer unconditional support? (Reference: page 195).
  • Analyze this: “Doulas advocate evidence-based care for physiologic birth, yet are not trained clinically to recognize or treat women when their pregnancies and labors become non-normal”. (Reference: page 37).
  • The original purpose of the first doula organizations was to provide moral support for each other. What do we need from our organizations now? (Reference: page 90)
  • Do we have the training to be professionally non-judgmental? (Reference: page 196).
  • Doula neutrality –When do you abandon it? How do you maintain it? (Reference: page 261).
  • What are the current debates around our standard of practice and code of ethics? (Reference: page 81).
  • Outcome-based care vs emotional companionship: What are you drawn to in this work? (Reference: page 260)
  • Are you comfortable with the “outsider-within” role? Does attract or repel you? (Reference: page 36)

How do you talk about doulas in your childbirth classes?  In your midwifery or obstetrical practice?  Have you read Birth Ambassadors?  What were your big take-aways?  Have you shared Lamaze International’s “Who Says Three’s a Crowd?” infographic with the families you work with?

Note: Christine Morton is a member of Lamaze International’s Board of Directors.

About Kim James 

Kim James HeadshotKim James BA, BDT(DONA), CD(PALS), ICCE, LCCE, is an ICEA and Lamaze certified childbirth educator teaching at Parent Trust for Washington Children/Great Starts where she sits on the Education Committee. She owns and operates www.DoulaMatch.net and is a DONA International and PALS Doulas certified birth doula as well as a DONA-approved birth doula trainer working at the Simkin Center/Bastyr University. Kim also volunteers her time on the Lamaze International membership committee and serves as Washington State DONA SPAR. Her daughters are 9 and 16 years old.  Kim and her family live in Seattle, Washington.

Babies, Book Reviews, Childbirth Education, Doula Care, Guest Posts, Healthy Birth Practices, Lamaze International, Newborns , , , , , ,

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