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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.

 

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BABE Series: Postpartum Survival Kit – Helping Families Be Ready for Life with a Newborn

May 26th, 2015 by avatar

By Cara Terreri, LCCE

PSK BABEMay’s Brilliant Activities for Birth Educators (BABE) idea is all about the postpartum period.  Lots of families don’t realize that good childbirth classes not only prepare families for the labor and birth but can be a wealth of information about the first weeks with a new baby.  Today on Science & Sensibility, Cara Terreri, LCCE shares her classroom activity to help families get ready for what happens after the birth – when they bring that new little one home. – Sharon Muza, Science & Sensibility Community Manager 

Introduction

The postpartum period is an important component of childbirth education. As we know, preparation for the birth of a child isn’t enough. And unfortunately in our culture, postpartum needs aren’t given a lot of attention, which means that parents often feel unprepared, confused, and frustrated during the early days and weeks after baby comes home.

For my childbirth classes, I developed a fun and interactive activity to introduce and discuss the many topics related to postpartum. The exercise can be a stand-alone activity (in a refresher childbirth class) or used as an opener to more in-depth activities and lessons on postpartum in an entire series. My inspiration for creating the “Postpartum Survival Kit” was the wonderfully humorous “Postpartum Robe,” a trademark teaching tool from Teri Shilling, MS, CD(DONA), IBCLC, LCCE, Passion for Birth founder and Lamaze educator, as well as Lamaze Childbirth Educator Seminar trainer.

The Postpartum Survival Kit (PSK) consists of a large plastic container with lid (mine also includes a handle, which helps for easy transport), and includes 23 items representing different issues or experiences a family may encounter during the postpartum period. The items represent everything from the physical recovery after birth (peri bottle, thick menstrual pad, and hemorrhoid cream) to emotional issues, like the importance of finding “me time” and postpartum mood disorders.

How It’s Used

In my classes, after introducing the topic of the postpartum period, I bring out the PSK, pass it around, and instruct families to take out 2-3 items (depending on the number of students in class). I then introduce the PSK and talk about how the different items represent typical encounters and issues during the postpartum. We then go around the room and each couple is asked to share the items they pulled and offer an explanation of their significance. Some items are more obvious, like the sleep mask for the importance of getting sleep when you can; some elicit giggles and awkward moments, like the KY jelly which represents the possible need for vaginal lubrication during intercourse if the parent is breastfeeding; and some items are confusing, like the mini manicure kit (taking “me time”) and the red golf ball (size of postpartum clots, what’s normal and what’s not).

photo 2When students share their items, I jump in when they (or the other students) cannot accurately describe the item’s meaning. I also open the floor for discussion with open-ended questions like “How would you cope?” and “What kind of support would you need if this should happen to you?” and “Who could you call on for help?” Depending on the size of your class, this exercise can take up a good amount of time, so be sure to plan appropriately and be prepared to reel in side discussions should it get off course.

Takeaways

Parents in my classes really enjoy this exercise. I get a lot of laughs, bewildered looks, and “lightbulb” moments. It’s always interesting to see how often the non-birth parent accurately describe the significance of items in this exercise – there have been many moments where the pregnant person is stumped, but the partner knows. In these instances, the exercise provides reassurance to both parents that the knowledge on what to expect during postpartum is intuitive. Additionally, I have found that this tangible exercise helps reinforce learning and memory when we talk more in depth about postpartum issues later in the class.

Modifications

The PSK exercise can be modified in several ways. I’ve used it in coordination with a worksheet, which could also be turned into a competition between families. If using in a private class, you can have each family member take turns with each new item. You could also use the exercise as an interactive teach-back. Ask each family to take out 2-3 items, learn about their significance (offer assistance if they are completely stumped), and then return to the next class and teach the other students.

The PSK also could be replicated for use in teaching the stages of labor and breastfeeding. Create a similar, smaller kit for each stage of labor and/or breastfeeding and begin the segment with the kit. For example, a Transition Kit may include a focal point, washcloth, water bottle, and mini bullhorn (to signify the “take charge” routine). 

Contents & Creating Your Own

The fun part about creating a PSK is making it uniquely your own! Some of the items will naturally be the same (lochia pad, hospital underwear, peri bottle, breastfeeding pads, for example), but others are limited only by your creativity! Consider the ways in which you can demonstrate postpartum mood disorders, changing emotions, dividing up hours in the day, eating nutritious food, sleep, etc. Items included in my Postpartum Survival Kit are:

  • Water bottle – keeping hydrated
  • Hospital underwear and pad – postpartum bleeding
  • Peri bottle, Dermaplast, and ice pack – perineal healing
  • Elastic abdominal brace – cesarean healing and core strengthening
  • Plate with balanced meal – postpartum nutrition
  • Ibuprofen – normal aches and pains
  • Hemorrhoid cream – a not uncommon postpartum issue
  • Stool softener – this is an important concern for many!
  • KY Jelly – lubrication issues
  • Condoms – postpartum fertility/birth control
  • Eye mask – getting sleep
  • Small red balloon paired with giant red balloon – involution, postpartum tummy
  • Hand mirror with puzzled/confused face – postpartum mood disorders (“I don’t recognize myself”)
  • Laminated speech bubble with “helpful” advice – dealing with influx of family/friend advice
  • Cloth breastfeeding pads – leaking nipples
  • Stuffed heart toy with wide open arms – finding and accepting support
  • Do not disturb door hanger – limiting visitors is ok; family time is important
  • Small baby doll with a heart and question mark on her tummy – conflicting emotions a baby often brings
  • Encouragement flags – encourage and praise your partner
  • Manicure kit – making time for yourself
  • Pill box modified to read “house, partner, work, baby care, errands, etc.” and filled with 24 beads, divvied up into the different compartments – how will you divide your time

 What else might you add to your customized Postpartum Survival Kit? There are many ways to teach about adapting to and surviving the postpartum weeks.  How do you teach about the postpartum period in your childbirth classes?  What activities have you found effective?  Share with all of us in the comments section.  If you have a “BABE”  to share in future posts – please contact me and let’s talk. – SM

About Cara Terreri, LCCE

© Cara Terreri

© Cara Terreri

Cara is a Lamaze Certified Childbirth Educator, doula, and site administrator for the Lamaze parent blog, Giving Birth with Confidence. She teaches and works in Myrtle Beach, SC, where she lives with her husband and three children. You can learn more about Cara at Simple Support Birth.

 

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Lamaze International Wants to Recognize Childbirth Education Leaders! Submit Your Nominations Now!

May 21st, 2015 by avatar

NominateDid you know that Lamaze International has several different awards that are given during the annual conference to recognize the contributions of deserving individuals to the field of childbirth education?  There are a total of four awards available, read about all four and consider if you have someone deserving of a nomination.

The Lamaze International Elisabeth Bing Award recognizes a Lamaze certified childbirth educator (LCCE)  who has “made outstanding contributions in the field of childbirth education.”  With Elisabeth’s passing late last week, after a long and productive life as the pioneer of childbirth educators, this award will be extra poignant in 2015.  Can you think of an educator who has achieved national or international recognition, embodies the principles of Lamaze International and has made positive contributions to the field of childbirth education? This year’s recipient will be joining prestigious past winners.  Please consider nominating a deserving educator so that they can be considered for this year’s award.

The Lamaze International Research Award is to honor the person or organization whose research has significantly contributed to the field of childbirth education and normal birth.  This award recognizes and encourages the need for ongoing research in the field of childbirth education to support the evidence-based content of Lamaze education and information.

The Lamaze International President’s Award is given at the discretion of the President to an individual or organization that embodies the spirit of the Lamaze mission and vision, and has made significant contributions to advancing safe and healthy pregnancy, birth and early parenting through evidence-based education and advocacy.

The Lamaze International Media Award is for Lamaze International to honor individuals or organizations that present normal, physiologic birth and/or Lamaze International in a positive light in the mass media. Can you think of a blogger or journalist who has worked hard to provide both consumers and professionals with accurate information on current best practice?  If so, consider nominating him or her to be considered for this award.

In order to nominate an individual or an organization for any of the above awards, please submit the nomination through our online form.  We ask you to also email a copy of the nominee’s CV/resume.  The Executive Committee will review the nominations in each category and select the award recipients.

The awards are presented at the annual conference, this year to be held September 17-21, 2015 in Las Vegas, Nevada.  Recipients are informed in advance so they may plan on being in attendance to receive their award. The deadline is June 1st, so don’t delay in submitting the names of deserving individuals.

Registration is now open for the conference, so take advantage of early registration savings by registering now.

 

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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 , , , , , ,

Great Line-up of Plenary Conference Speakers and President’s Desk Updates

May 14th, 2015 by avatar

lamaze icea conf 2015Today on Science & Sensibility – news you can use!  Plenary speakers have been announced for the upcoming conference and Robin Elise Weiss, Lamaze International’s Board President has a new series of informative videos called “From the President’s Desk” that you will want to check out.  Read on for information on both of these topics.

Lamaze/ICEA Joint Conference News

Lamaze International and the International Childbirth Education Association (ICEA) just announced their plenary (general session) speaker line up for the joint Lamaze/ICEA 2015 conference at Planet Hollywood, Las Vegas on September 17-20.  Four speakers will address the entire conference in general sessions and I am very much looking forward to listening to their presentations along with the many concurrent sessions that will be offered over the four days of the conference.

ICEA and Lamaze celebrated their 50th anniversaries together in 2010 in Milwaukee, WI with a well attended “mega-conference” that had great energy and educational offerings and I expect that this conference will be just as big and wonderful.  Bringing together two leaders in childbirth education to hold a joint conference means that all attendees will benefit in numerous ways.

The theme of the Las Vegas conference is “Raising the Stakes for Evidence Based Practices & Education in Childbirth” and I know that educators, doctors, midwives, doulas, L&D nurses, IBCLCs and others will come together and take advantage of this joint conference to network, learn, receive contact hours, and socialize with other professionals.  Maybe, even win a little at the blackjack tables or take in a great show.  Las Vegas is a great venue for this conference, offering a wide variety of locales, activities and nightlife to enjoy outside of conference  hours.

This year’s plenary speakers

camman head shot 2015William Camann, MD
Director of Obstetric Anesthesia, Brigham and Women’s Hospital,  Associate Professor of Anesthesia, Harvard Medical School

Presentation: What does the informed childbirth educator need to know about labor pain relief in 2015?

 

 

combellick head shot 2015Joan Combellick, MSN, MPH,CM
PhD Student, NYU College of Nursing
Midwife, Hudson River Healthcare

Presentation: Watchful Waiting Revisited: Birth Experience and the Neonatal Microbiome

 

 

Joseph head shot 2015Jennie Joseph, LM, CPM
Co-Founder and Executive Director
Commonsense Childbirth School of Midwifery

Presentation:The Perinatal Revolution: Reducing Disparities and Saving Lives through Perinatal Education and Support

 

 

mcallister head shot 2015Elan McAllister
Founder, Choices in Childbirth

Presentation: No Day But Today

 

 

 

 

Concurrent sessions

Watch the website for soon to be released information on concurrent speakers and their topics.  Concurrent sessions will fall into one of four categories:

  • Evidence-Based Teaching and Practice
  • Using Technology and Innovation to Reach Childbearing and Breastfeeding Women
  • New and Emerging Research in the Field of Childbearing and Breastfeeding
  • Challenges of the Maternal Child Professional

Preconference workshops

Additionally, there will be two preconference workshops available for a small additional fee.  These 4 hour workshops allow you to really immerse yourself in the topic and leave with concrete skills applicable to your work with childbearing families.

  • Movement in Birth (AM)
  • Social Media Smarts: Strategic Online Marketing for the Busy Childbirth Professional (PM)

Early bird registration is open until August 1, 2015, so registering now allows you to save money on the conference fees and make your travel and hotel plans now.  Look for interviews with the plenary speakers over the next few months on Science & Sensibility.

 From the President’s Desk

Board President Robin Elise Weiss, Ph.D, has recently made a series of short and useful videos for Lamaze International on several topics.  The video series is called “From the President’s Desk”. Released to date are several on cesareans;

Robin’s newest video discusses the recently released ACOG committee opinion “Clinical Guidelines and Standardization of Practice to Improve Outcomes“. This video helps both birth professionals and consumers to understand how pushing for the best evidence based care can result in both pregnant people and their babies having improved outcomes.  ACOG wants to be able to offer best practice to those receiving care from its members, and consumers can help by sharing their desire to receive care in line with recommended guidelines.

Head over to Lamaze International’s YouTube Channel to see all the offerings, share the relevant videos with your students and clients and subscribe to the channel so that you don’t miss any of the releases.

2015 Lamaze & ICEA Joint Conference, ACOG, Cesarean Birth, Childbirth Education, Conference Calendar, Conference Schedule, Continuing Education, Lamaze International, Lamaze News , , , , , , , , , , , ,