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Remembering Elizabeth Noble and Her Contributions to Maternal Infant Health

January 7th, 2015 by avatar
© Elizabeth Noble

© Elizabeth Noble

Elizabeth Noble, author, presenter, teacher, and advocate for mothers, babies and families, passed away last week after spending time in hospice care.   Elizabeth was a highly respected physical therapist and internationally recognized expert on, and an advocate for, the normal physiology of pregnancy, birth and postpartum. Born and raised in Australia, Elizabeth received degrees in physiotherapy, philosophy and anthropology before she moved to the United States in 1973.  In 1977, Elizabeth founded the Section on Women’s Health for the American Physical Therapy Association.  In 1979, Elizabeth also founded the Maternal and Child Health Center in Cambridge, MA, along with Cambridge Physical Therapy.  She was the director of these organizations until 1990.

Elizabeth Noble authored eight books; Essential Exercises for the Childbearing Year (her most well known), Having Twins and More, Childbirth with Insight, Marie Osmond’s Exercises for Mothers to Be, Marie Osmond’s Exercises for Mothers and Babies, Primal Connections, The Joy of Being a Boy, and Having Your Baby by Donor Insemination.  Many of these books have been translated into several other languages.

Elizabeth created several multimedia productions (videos, DVDs and CDs) that included Inside Experiences, Channel for a New Life, BabyJoyExercises and Activities for Parents and Infants, Essential Exercises for the Childbearing Year and Marie Osmond’s Exercises for Mothers-to-Be and Pelvic Power.

Elizabeth authored  several articles, chapters and forewords and was a member of the editorial board of the International Journal of Pre- and Perinatal Psychology and Medicine, and Primal Renaissance: The Journal of Primal Psychology. A former Director of the Association for Pre- and Perinatal Psychology and Health, she has served on the boards of many organizations such as ICEA, The Toronto Birth Center, Center for Loss in Multiple Pregnancy, and Dancing Through Pregnancy®.

Elizabeth was the creator of “Instructor Training in Prenatal and Postpartum Exercises” a three day course geared for professionals.  She presented this frequently all over the world.

Some of her well known lectures and presentations included:

  • Optimal Health
  • Deskercises
  • Say What You Mean!
  • Pelvic Power: An Evening Public Presentation
  • Pre- and Perinatal Origins of Mental and Physical Health
  • Preventing Professional Burnout: Personal Growth for Maternity Care Providers
  • Hands-on Pelvic Assessment & Treatment
  • Prenatal Preparation
  • Empowerment Challenges for Expectant and New Parents
  • Psychophysical Aspects of Pain in Labor
  • The Pregnancy Playshop:  Weekend Childbirth Intensive for Expectant Parents
  • New Dimensions in Support for Childbearing Year
  • Childbirth Preparation and Unfulfilled Transitions
  • Reproduction and Birth in A Technological World
  • Marching Backward: The Malaise in the Natural Childbirth Movement
  • The Power of Knowing: Psychological Strategies for Expectant Parents and Maternity Care Providers
  • Tapping the Unconscious Mind
  • Inside Experiences: Guided Recall for Birth & Before
  • Reproductive Technology
  • Anonymous Donor Gametes and Genealogical Bewilderment
  • Multiple Pregnancy
  • Fetal Surveillance and the Nocebo Effect: Recommendations for a Normal Pregnancy, Vaginal Birth Optimal Outcome.
  • Pre and Perinatal Loss of a Twin
  • Bonding with Multiples
  • Sharing Space: Twinship Experiences in the Womb

Elizabeth’s dear friend and colleague, Nancy Wainer, CPM, had this to say about Elizabeth Noble:

Liz was quite unique- well-educated, well-read, well-traveled, well-spoken, opinionated (because she was educated!) and feisty. She was extremely articulate and was most dedicated to mothers and babies.

Liz took excellent care of herself – her diet/nutrition was excellent and she exercised regularly. She was mindful.  She had so many things she wanted to accomplish in her lifetime, both professionally and personally. It seems so unfair to those of us who knew her that she was stricken with this dreaded and painful disease, cancer, and that she succumbed this past week. For the past decades, she has been a driving force for mother and babies and and natural living (having had her own home birth in a tub outside on a beautiful day at her’s and Leo’s lovely home in Harwich) and was knowledgeable about so many aspects of birth that made her a true pioneer/trail blazer. She was cut out of a very special mold and her absence will be surely be felt in our circles. Her list of accomplishments are a mile long, and should have been another full mile. Rest in peace, dear Liz… rest in peace.

© Elizabeth Noble

© Elizabeth Noble

The Section of Women’s Health (APTA) recognized Elizabeth by establishing The Elizabeth Noble Award, given yearly to an APTA member in good standing who has provided extraordinary and exemplary service in the field of women’s physical therapy.

Many in the birth world are very familiar with all of Elizabeth Noble’s many contributions to mothers and babies and had the deepest respect for her significant accomplishments.  Her voice and her knowledge cannot be replaced and will certainly be missed.  All of us at Science & Sensibility and Lamaze International offer our condolences to the Noble family.

Babies, Childbirth Education, Newborns , ,

Best in Birth for 2014

December 30th, 2014 by avatar

By Cara Terreri, LCCE

Best of  BirthAs the year winds down this week, many will take stock of the best and worst of happenings throughout the year. In the world of maternity care, there are several notable and promising advances, discoveries, and recommendations in care practices. ICYMI (in case you missed it), we’d like to share the best in birth for 2014.

The Journal of Midwifery and Women’s Health released important new U.S. research on the outcomes of home birth entitled Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009.” This was the first study on outcomes of home births since 2005. For a in-depth review of the study, check out this and this.

In February, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine issued a joint Obstetric Care Consensus Statement: Safe Prevention of the Primary Cesarean Delivery. The statement aims to change the way practitioners manage labor in an effort to reduce the cesarean rate, and was considered by many a major game changer in how women are cared for in labor. The ACOG press release is here, which provides more detail of the study. Science & Sensibility covered it here.

Evidence Based Birth a well-respected resource site for birth practices, published the article, “Evidence for the Vitamin K Shot in Newborns,” which examines Vitamin K deficiency bleeding (VKDB), a rare but serious consequence of insufficient Vitamin K in a newborn or infant that can be prevented by administering an injection of Vitamin K at birth. The article helps to clear up many misconceptions and questions surrounding the Vitamin K shot.  Sharon Muza interviews Rebecca on this topic here.

Lamaze International launched a series of online parent classes that cover a variety of topics on pregnancy, birth, and breastfeeding. The online classes are presented in an interactive, engaging format with unlimited access so you can complete the class at your own pace. They provide vital information, and are recommended to be followed up with a traditional, in-depth childbirth class. Topics covered include, VBAC, Six Healthy Birth Practices, and Breastfeeding Basics.  A Pain Management and Coping Skills class will be released shortly in the new year.

The journal Birth published a study that compared the difference between nonpharmacologic (aka: non-drug) pain management during labor with more typical pain relief techniques. Results showed that nonpharmacologic pain relief techniques can reduce the need for medical interventions. Read an in-depth review here.

The “family-centered cesarean” birth continued to emerge as an option for more families as new providers and hospitals adopted practices to facilitate the approach. For more information, check out the Family Centered Cesarean Project and this article.

Out-of-hospital (OOH) births rates continued to increase, according to a report from the National Center for Health Statistics released this year. The report also showed that OOH births generally had lower risk than hospital births, with lower percentages of preterm birth and low birth weight.

Work continued on human microbiome (aka: healthy gut bacteria) research, and further investigation is underway on the impact of cesarean birth and infant gut bacteria colonization, and the potential benefits of artificially transferring mother’s bacteria to baby.

What other groundbreaking maternal infant topics do you feel made a big leap in 2014?  Share the topic and any relevant links in our comments section.

About Cara Terreri

cara headshotCara began working with Lamaze two years before she became a mother. Somewhere in the process of poring over marketing copy in a Lamaze brochure and birthing her first child, she became an advocate for childbirth education. Three kids later (and a whole lot more work for Lamaze), Cara is the Site Administrator for Giving Birth with Confidence, the Lamaze blog for and by women and expectant families. Cara continues to have a strong passion for the awesome power and beauty in pregnancy and birth, and for helping women to discover their own power and ability through birth. It is her hope that through the GBWC site, women will have a place to find and offer positive support to other women who are going through the amazing journey to motherhood.

ACOG, Childbirth Education, Evidence Based Medicine, Guest Posts, Lamaze International, New Research , ,

Great Holiday Gift Ideas for your Favorite Childbirth Educator

December 16th, 2014 by avatar

SandS Great Gift IdeasAs the gift giving season is fast approaching, I wanted to put together some great gift ideas that any childbirth educator would love to receive this holiday season.  Stocking a childbirth education classroom with useful items can be expensive and even overwhelming for the educator just starting out.  Here are some must-have items that any childbirth educator would appreciate now or anytime during the year. Childbirth educators – what might be on your list that I did not included here? And, go ahead and print this list out or share online with friends and family,  so you can receive a CBE gift to warm your heart and that demonstrates how much your efforts to help families have a safe and healthy birth are appreciated.

A pelvic model

Having a pelvis on hand to demonstrate how the baby moves through the pelvis, rotating and descending during labor is a key part of any childbirth class.  Your favorite CBE will appreciate having one to use and they are often an expensive purchase.  I like this one for both it’s price, quick delivery and excellent reviews.  This is one of my most valuable teaching aids.

A knitted uterus

Having a knitted uterus is helpful for demonstrating how the cervix thins and opens during labor and birth. A knitted uterus can be purchased through various stores that sell childbirth teaching aids, or even on Amazon.com and often come with special features like detachable vagina and zippered uterine opening to represent a cesarean incision. If you are in any way crafty, you could consider knitting your own, using one of the many patterns that are available on line and customize it using the childbirth educator’s favorite colors.

www.etsy.com/shop/Anatomicalknits

www.etsy.com/shop/Anatomicalknits

A fetus

Having a fetal model to fit into the uterus and move through the pelvis makes for a great visual aid.  Childbirth Graphics sells one that fits through the standard model pelvis and holds up well through years of use.  You can also look around at some of the other sites listed below for comparison.

Bluetooth speakers

I am always grateful for my small, portable  but powerful rechargeable bluetooth speaker that I can connect to my phone, my tablet or my laptop for quick and easy sound projection.  I have had a few over the years and am currently thrilled with the Jam Classic in a color to match my classroom.  I previously owned this one until my teen daughters snatched them away. Buy your favorite, just make sure they are lightweight, rechargeable and work over bluetooth.

A subscription to “Up to Date”

I would love to be gifted a subscription to the research website “Up to Date” which provides current evidence based information and practice guidelines at your fingertips.  When a childbirth educator wants quick and easy access to all the most current information on treatments, protocols and recommendations for maternity care, s/he can quickly access this highly current resource.  While we are not clinicians, it is so helpful to be able to see the most current research as it is made available.  This gift would thrill me to no end.

Lamaze membership

Your favorite childbirth educator would love to have his or her Lamaze membership paid for!  S/he will get all the benefits of being a Lamaze member, including significant Kinkos/FedEx discounts, a year long subscription to the Journal of Perinatal Education, access to community boards on the Lamaze website and so much more.

Peanut and/or birth ball

peanut ballNo childbirth class is complete without a peanut or regular birth ball for the educator and students to use during classroom demonstrations and practice.  Lots of different sizes to choose from, but I recommend the 45 CM peanut ball and the 65 CM birth ball, likely to be the best size for many of the students.  Make sure the ball you buy is burst resistant.  You can get them on Amazon or at local sporting goods shops as well.  Here is some information on using the peanut ball during labor.

Unscented massage lotion or oil

Hand massage is often taught in childbirth classes as a form of relaxation.  Keep your favorite childbirth educator well supplied with a large bottle of a quality unscented lotion or oil.  Consider adding in some small plastic or glass bottles that s/he can fill an  handout during practice time and you will have a sure winner!

Newborn dolls

ikea dollIt is always fun to have a collection of newborn dolls to hand out when talking about life with a newborn, to practice swaddles with or to use during breastfeeding practice.  My favorite doll is the soft dolls available at at Ikea.  They are lightweight, about the right size, and at $10/each, very affordable, so I can purchase enough for every family to have one to practice on. I also like that they have different races, so my dolls can reflect my class members.

Laminator

I like to teach engaging and interactive childbirth classes and many of my activities involve cards as part of the learning.  I love having my own laminator so I can whip up new teaching tools and ideas right in my own home.  This affordable laminator has been a reliable workhorse for me for several years now without fail and I love making  professional looking materials to use in my childbirth class. I like to have two size lamination sheets – full page and quarter page.

Astrobrights colored paper

My handouts and laminated activity cards look fantastic on this super bright, super fun colored paper.  I love having a ream around the house for all my signs, projects and creative ideas. I also find the heavier cardstock useful at times too.

All kinds of markers, crayons and pens

There is nothing so sad as having a box of faded out, washed out permanent or low scent dry erase markers in my teaching supply box.  I love when the markers are bold and the dry erase/white board markers are strong and vibrant.  I always appreciate having a new supply on hand of both kinds of markers. I also use crayons in my classes and they get broken and used up!   A huge box of crayons would be super.  Even a jumbo box of pens – as students are always asking to borrow them and I never get them back.

Knitted breasts

knitted breasts

creative commons licensed (BY-NC-ND) flickr photo by seniwati: http://flickr.com/photos/seniwati/3182485430

If the childbirth educator on your list also teaches breastfeeding , she will want to have a nice collection of knitted breasts on hand for her classes.  This model is nice but rather expensive, It is nice to have one for each family.  Here is a pattern if you have the skills to make them yourself.  Or you can often find them on Etsy Remember, breasts can come in many different skin tones and all kinds of nipple, areola and breast sizes.

Swaddling blankets, cloth diaper samples, baby carriers

These may be things you have access to from your children as they have grown out of them, or you can take up a collection of used items from friends and family or even hit up the thrift shops.  Get a whole bunch together and gift them to the childbirth educator to use in class.  S/he will appreciate the variety and feel confident that s/he has enough for everyone in class to try some.

Gift certificates

If you are not sure what your childbirth educator needs – consider a gift certificate to one of the companies that sells teaching aids and instructional materials, and let the educator decide for him or herself what they can use.

Cascade Healthcare Products

Childbirth Graphics

Injoy Videos

Plumtree Baby

 

 

Childbirth Education, Social Media , , , ,

Series: Building Your Birth Business: Online Marketing for Birth Professionals – A Beginner’s Guide

December 11th, 2014 by avatar

By Janelle Durham, MSW, LCCE

As we move into the new year, you may be considering starting your own independent childbirth education or birth related business.  Maybe you already have such a business already established but are looking to take it to the next level. Today’s post is part of a new series: Building Your Birth Business.

 Perhaps the organization you work for would like to grow their offerings geared toward families in the childbearing year.  Janelle Durham, a birth and parent educator, working for several programs in the Pacific Northwest has put together this beginner’s guide for the options available to reach your target audience of expectant parents through online marketing.  This resource can help you to get started in designing and placing ads and then tracking your success. – Sharon Muza,  Science & Sensibility Community Manager

Introduction

This guide is designed for non-profit organizations or individuals that serve expectant parents or young families (though other programs may also find it useful). I know there are a lot of folks doing great work, but we all have limited advertising budgets, and it’s hard to get the word out sometimes. We try things like a print ad in the newspaper once a year for $250 and hope that gets us some people.(But ask today’s parents if they read the newspaper.. I’m guessing the answer will be no. Most of the people who see your newspaper ad will be past the age of child-rearing. They’re not your target audience.)

social-media-marketingWith today’s online marketing, there are much more effective ways to spend your ad dollars that allows you to put your ad in front of a very targeted audience of young parents in the places where they look everyday (Facebook, online search engines, and YouTube. To see statistics on who uses social media, click here.)  Here’s an overview of your options, with links to more details. (And, of course, once you have the basic vocabulary and ideas I share here, you can do online searching to learn lots more about all these topics.)

Facebook Ads

71% of people who use the Internet use Facebook. 63% of Facebook users visit Facebook every day. (source) This is where parents’ eyes are looking!

Facebook ads allow you to place an ad right on the user’s “feed” – not off on a sidebar that they’ve learned to ignore. They can just read the ad, or they may choose to click on it. (You choose what happens when they click – they could click to like your Facebook page, or the click could link to your website.) You only pay if they click on your ad.

Facebook ads let you target your preferred customer or cient. For example, I can target my ad to people that Facebook has determined are: women, 24 – 44 years old, living in Bellevue, WA or within a ten mile radius (but excluding Seattle) who have purchased baby food, toys for young children, or clothes for young children. Facebook says that’s a possible audience of 5800. For $10, I put an ad in front of 995 of those parents, 23 clicked through to our website to learn more. That’s 43 cents for each person who came to our site to learn more – good bang for your buck! How to place ads on Facebook.

Facebook Boosts

Facebook also allows you to “boost” a post. So, you write a regular post on your business page and all your page followers see it. Then you pay for a boost to put it on the feeds of people who don’t yet follow your page. For $10 I boosted a post about local classes to local parents. It displayed to 1745,  and 36 clicked through. Cost 28 cents a click. How to Boost.

Your ability to target your demographic is more limited with boosts than with Facebook ads, so I prefer ads. I do like using boosts to promote a link to a video. (see below)

Google ads and Bing ads

The big picture is: you create a short ad. You choose whether it will display on search networks, display networks, or both. Then you define what kinds of people to show it to (geographic region, etc.). Then you define “keywords.”

For “search network advertising”: When someone in your region searches for those keywords, then the ad will display. For “display network” your ad will appear when people are looking at related content, even if they didn’t use your search terms to get there. When I ran ads on Bing, for $10, the ad would display to about 500 people, and about 25 would click through. On Google, $10 would display to about 1500 people, but only about 9 or 10 would click through. If you were just trying to get your name out there, Google may be a better bet, because there’s more “impressions” (times your ad is shown.) If you really want people to click to your site to learn more, Bing may be a better bet, because more will click through. Or, you may choose to run a low budget ad on both networks to reach the widest variety of users.

I personally prefer Facebook ads to search engine ads, because as a user, I find I read Facebook ads, and I totally ignore search engine ads. Also, Facebook allows me to target more specifically. However, if you think people will be actively searching out programs like yours and you have a really good sense of what keywords they would use, search engine ads are certainly worth doing. Learn how to place ads on Google and Yahoo Bing.

Promoting a video

You may choose to make a video to promote your program. If you do, then upload it to YouTube, then embed it somewhere on your website (check the help info in your website tool to learn how to do this.) Then promote it.

On Facebook, you can put a post with a link to the video, and then boost that post. (My $10 test ad displayed to 1700, and 62 clicked through.) On Google Ads, you can create a “video campaign” (learn how and learn more). Ads display on YouTube. (My test ad displayed to about 950 people, 24 clicked through.) Or you can set up your ad (“promote your video”) on YouTube directly. (Learn how.)

Check your web presence

When you spend money on internet advertising, most of those ads will take people directly to your website to learn more about your program. PLEASE make sure your website is the best it can be, free of grammar and spelling errors, graphically pleasant  and contains all the essential info they would need! Learn more here.

Is it working?

When you spend money on an ad in traditional media (newspapers, mailings, radio ads), it can be hard to tell: how many people saw the ad? How many were your target demographic? Did they take any actions after seeing the ad?

It’s easier to get those answers for online advertising. All the services listed above will give you all sorts of statistics (analytics) on how many people saw the ad, how many clicked through, what portion of the video they watched, and so on. This helps you decide whether the ad was money well spent.

It’s even better if you can take this to the next level. Many websites allow you to see your statistics. So, for example, on a day you ran an ad, you can see not only how many people clicked in from your ad, but what they did once they got to your site. Did they click on links on the page? Did they look at other pages? How much time did they spend on your site? There are also some external tools that can track statistics, like Google Analytics.

It’s even better if you can do “conversion tracking” which shows more specifically what a user did on your site after clicking through from an ad. These articles might be helpful to you: How to Track Facebook Ad Conversions and Understanding Conversion Tracking.

Staying up to date

The world of internet advertising is always changing, so if you want to be effective, update your website and your marketing strategy on a regular basis.

In this overview, I’ve shared what I learned this summer about online marketing. I need to say that the online world changes very quickly, and the processes might not be the same and you might not get the same results in September 2015 as I got in September 2014.

Have you had any experience with online marketing for your childbirth education or other birth business?  Please share your successes and learning moments with us in the comments section. – SM

About Janelle Durham

Janelle headshotJanelle Durham, MSW, LCCE. Janelle has taught childbirth preparation, breastfeeding, and newborn care for 14 years. She trains childbirth educators for the Great Starts program at Parent Trust for Washington Children, and teaches young families through Bellevue College’s Parent Education program. She is a co-author of Pregnancy, Childbirth, and the Newborn and writes blogs/websites on: pregnancy & birth; breastfeeding and newborn care; and parenting toddlers & preschoolers. Contact Janelle and learn more at www.janelledurham.com

 

Childbirth Education, Guest Posts, Lamaze International, Series: Building Your Birth Business , , ,

Series: Welcoming All Families: Supporting the Native American Family

November 18th, 2014 by avatar

By Melissa Harley, CD/BDT(DONA), LCCE

November is Native American Heritage Month and LCCE Melissa Harley shares some interesting facts about the rich culture included in some of the varied childbearing year traditions observed by some of the U.S. tribes.  There are many different tribal nations, and each one has their own ceremonies and practices around pregnancy and birth.  Beautiful and fascinating stories that are each unique in their own right.  This post is part of Science & Sensibility’s “Welcoming All Families” series, which shares information on how your childbirth class can be inclusive and welcoming to all. – Sharon Muza, Community Manager, Science & Sensibility.

© Bob Zellar http://bit.ly/1EVALCk

© Bob Zellar http://bit.ly/1EVALCk

As childbirth educators of today, we must strive to have a connection to childbirth of yesterday.   As educators, we should continually be looking for ways to be welcoming of all cultures, customs, and traditions in the classroom setting and when working individually with students.  In order to achieve these goals, it is helpful to better understand how such traditions played out in years gone by.  So often, we look at birth from a very telescopic lens of the past (singling out one or two cultures) rather than looking at history from a more wide panoramic view point.  As we strive to embrace cultural diversity, we should continue to explore populations that are perhaps a little less known.    Have you considered the culture of Native Americans in childbirth and how the past compares to childbirth in our society now? According to the Centers for Disease Control and Prevention (CDC), currently, there are roughly 5.2 million American Indians and Alaska natives spread throughout 565 federally recognized tribes in the US. (CDC, 2013)  Let’s take a look at some of the commonalities that we have with our Native American ancestors and learn a little together about being welcoming, helpful, and inclusive of Native Americans in our classes today!

Native Americans and Pregnancy

Although there are some differing opinions regarding historical pregnancy and birthing traditions of Native Americans, according to historian Ellen Holmes Pearson, PhD, Native Americans were known to take exceptional care of themselves during pregnancy.  Similar to today, maintaining good health throughout pregnancy often led to an uncomplicated labor and birth.  Much regard was taken to ensure that a Native American mother’s health needs were met in a way that would support the nutritional and physical needs of both mom and baby.  From the website teachinghistory.org, Dr. Pearson states   “During their pregnancies, women restricted their activities and took special care with their diet and behavior to protect the baby. The Cherokees, for example, believed that certain foods affected the fetus. Pregnant women avoided foods that they believed would harm the baby or cause unwanted physical characteristics. For example, they believed that eating raccoon or pheasant would make the baby sickly, or could cause death; consuming speckled trout could cause birthmarks; and eating black walnuts could give the baby a big nose. They thought that wearing neckerchiefs while pregnant caused umbilical strangulation, and lingering in doorways slowed delivery. Expectant mothers and fathers participated in rituals to guarantee a safe delivery, such as daily washing of hands and feet and employing medicine men to perform rites that would make deliveries easier.”

In addition to caring for the body in pregnancy, it was extremely important for Native Americans to care for their mind and spirit.   In the Navajo communities, pregnancy and childbirth were approached as a spiritual event.  Much time and effort was spent making sure that the mother had a positive pregnancy.  Ceremonies in the Navajo community in general were very important.  Some ceremonies could last for days and days.  It was only natural that the tribes would hold Blessing Ways for expectant mothers.   Unlike many other Navajo ceremonies, the Blessing Way was not held to cure a sickness, but rather to invoke positive blessings and avert misfortune. Contrary to current use of the Blessing Way, the traditional Navajo tribes used the Blessing Way for more than just pregnancy and birth.  The ceremony was also used for blessing of the home, and also to enhance good fortune through the kinaalda (girl’s puberty rites).  Native Americans today that wish to connect with their heritage during the childbearing time often do so by being very careful about their spiritual surroundings.  It is quite important for mothers to keep their thoughts positive, and to maintain a climate of peace with those around them.  It is also suggested that mothers should avoid arguing with others during pregnancy, or to allow bad thoughts to enter their minds.

Native Americans and Birth

Native Americans were known to give birth in a simple way, with only other women in attendance as men were never allowed to see a woman give birth.   In general, Indian women likely gave birth without much assistance at all.  A midwife would at times attend the birth, along with other female family members from the tribe.  In very simplistic style, the baby would be birthed directly onto the leaves below the mother who used upright posturing for birth.   The baby would be welcomed by the earth, rather than by man’s hands.

To hasten labor and reduce pain during the birth, tribes sometimes utilized herbal remedies.   Cherokees made a tea with Partridgeberry and started consuming it several weeks before the birth.  They were also known to use Blue Cohosh to promote rapid delivery and to speed delivery of the placenta. To relieve pain, the Cherokees turned to wild black cherry tea made with the inner bark from the tree. The Koasati tribes made a tea of the roots from the plant of cotton that reduced pain for birthing women.

In some tribes, rituals to “scare” the baby out were utilized.  An elder female would often yell “Listen! You little man, get up now at once. There comes an old woman. The horrible [old thing] is coming, only a little way off. Listen! Quick! Get your bed and let us run away. Yu.”

Another common tradition in birth was the use of the rope or Sash Belt thrown over tree limbs for the mother to hold.  The traditional Navajo sash belt is made of intricate-colored sheep wool that is woven upon a wooden loom.  Some hospitals today near Indian reservations have a Sash Belt installed in the ceiling for mothers to use.

Connecting the Past and the Present

While the mothers of today might not fear that eating speckled trout will cause birthmarks, most do still have concerns  and want to take steps to ensure a healthy baby.  We see mothers avoiding large amounts of caffeine and high mercury fishes. While we don’t often see our students choosing to give birth without much assistance onto the leaves of the trees, many do still choose upright posturing.  We also see a desire at times to hasten the labor, and some mothers turn to herbal or medicinal means to help that happen.   As childbirth educators, we can at times be of comfort to our students as they prepare for the healthiest birth possible. We can connect the past with the present, allowing parent’s space to explore the traditions within their cultures while also honoring current evidence and research based maternity care.  As I say in my classes, while pointing students to the evidence associated with Healthy Birth Practice #5, those mamas from long ago knew something intuitive: that using upright positions for labor and birth made a difference!

Health Services for Native Americans Today

If you live and work near an Indian reservation, you may be familiar with Indian Health Service (IHS).   IHS was established in 1955 with a goal to raise the health status to the highest possible level for Native Americans registered in a federally recognized tribe.   As childbirth educators, some of our students may seek medical attention at one of the nation’s 33 IHS hospitals or 59 IHS health centers.   Dr. Michael Trujillo, past director of IHS states in regard to IHS, “The values of human dignity, honesty, compassion, coupled with shared values of many different tribes and cultures, that have come to be spoken of as “Indian values, of listening, mutual respect, dignity, and harmony must always be at the forefront of what we do and how we do it. We must be professional in all our actions.”

This year, in accordance with the Affordable Care Act, the Indian Health Care Improvement Act was permanently reauthorized.  This provision in the current law will increase access of quality health care to Native Americans near IHS facilities as well as those who do not live near an IHS facility.  The ACA includes some very specific benefits that will impact American Indians and Alaskan Natives.  Tribes across the country are encouraging members to become familiar with the new laws, and to evaluate how the provisions can increase access and affordability to quality healthcare for their members.

Connecting our Native American clientele with quality prenatal care is extremely important.   Consider the following statistics from the CDC:

  • American Indian/Alaska Natives have 1.6 times the infant mortality rate as non-Hispanic whites.
  • American Indian/Alaska Native babies are 2.2 times as likely as non-Hispanic white babies to die from sudden infant death syndrome (SIDS).
  • American Indian/Alaska Native infants were 2.5 times as likely as non-Hispanic white infants to have mothers who began prenatal care in the 3rd trimester or not receive prenatal care at all.

What’s a Childbirth Educator to Do?

As we strive to better serve the mothers of today, first and foremost, we should recognize the importance of the history that First Nations people bring to birth.   Many Native Americans today still practice customs and traditions from years gone by.  If you currently service a population that includes American Indians and Alaskan Natives, then you may already be aware of the customs in your area.

© Ursula Knoki-Wilson

© Ursula Knoki-Wilson

To help Native Americans feel welcomed in class, ensure that visuals of contemporary Native Americans are included in your curriculum.   You might also offer a segment in your comfort measures class that specifically addresses the customs from that population.  In general, keeping language inclusive of a variety of cultures can also lead to a sense of acknowledgement and acceptance. Simply recognizing that you are aware of different cultural traditions in class can lead to parents feeling more comfortable, thus opening a door for sharing and further education.

Regardless of your target clientele, it would be helpful for a childbirth educator to become familiar with the many different traditions surrounding childbirth in the cultures around us.  A quick internet search can lead to a wealth of information that might be helpful in class.  As with any tradition or culture that you are not familiar with, education is power!  If you are on or near a reservation, perhaps reaching out to the IHS facility nearby might be an option.  Some facilities have staff members that hold workshops and courses to help the people within their tribes stay connected with tradition. In addition, it might be helpful to inform area IHS facilities that there is a childbirth educator nearby who is sensitive to the mental, physical and spiritual needs of the tribe members. It would also be advisable for childbirth educators to become aware of the provisions in the ACA for American Indians, as to be prepared with resources, if you are asked any questions in regard to healthcare for American Indians.   As childbirth educators, we are in a unique position to encourage our clients to seek quality prenatal care.  Working together with the families in our classes, we can positively impact the infant mortality rates among these populations by educating the families about safe and healthy birth practices and the options available to them.

Ultimately, it is important to keep our space open for all cultures and honor the individual traditions of the parents that attend our classes.  By becoming more educated and sensitive to the cultures around us we can better serve our clientele as a whole.  And for our Native American students, I’ll leave you with this blessing:

Earth’s Prayer
From the heart of earth, by means of yellow pollen blessing is extended.
From the heart of Sky, by means of blue pollen blessing is extended.
On top of pollen floor may I there in blessing give birth!
On top of a floor of fabrics may I there in blessing give birth!
As collected water flows ahead of it [the child], whereby blessing moves along ahead of it, may I there in blessing give birth!
Thereby without hesitating, thereby with its mind straightened, hereby with its travel means straightened , thereby without its sting, may I there in blessing give birth!S.D. Gill, Sacred Words

Note: to read more information about the images of the cradleboard welcoming home two generations of families, please follow this link to the Turtle Track organization for the full story. – SM

References

American Indian & Alaska Native Populations. (2013, July 2). Retrieved November 15, 2014, from http://www.cdc.gov/minorityhealth/populations/REMP/aian.html

Blessingway (Navajo ritual). (n.d.). Retrieved November 15, 2014, from http://www.britannica.com/EBchecked/topic/69323/Blessingway

Holmes Pearson, E. (n.d.). Teaching History.org, home of the National History Education Clearinghouse. Retrieved November 15, 2014, from http://teachinghistory.org/history-content/ask-a-historian/24097

Infant Mortality and American Indians/Alaska Natives. (2013, September 17). Retrieved November 15, 2014, from http://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=38

Knoki-Wilson, U.M. (2008). Keeping the sacred in childbirth practices: Integrating Navajo cultural aspects into obstetric care. [PowerPoint slides].  Retrieved from Naho.ca website http://www.naho.ca/documents/naho/english/IG_Presentations2008/009KnokiWilsonUrsula.pdf

About Melissa Harley

melissa harley head shotMelissa Harley, CD/BDT(DONA), LCCE has worked with birthing women since bearing witness to the vaginal birth of her twin nieces in early 2002. She is a Native American registered in the  Cherokee Nation Tribe (OK) and the owner of Capital City Doula Services in Tallahassee, Florida.   Melissa holds certifications as a Lamaze Certified Childbirth Educator, DONA International Certified Doula and an Approved Birth Doula Trainer(DONA). She currently holds leadership positions with DONA International as a Florida state representative, and she sits on both the DONA International Education and Certification Committees.Melissa is a contributor to several birthing publications including the Journal for Perinatal Education (JPE), the Bearing Witness Series: Childbirth Stories Told By Doulas, and the sequel book Joyful Birth: More Childbirth Stories Told By Doulas.Married for 16 years and the homeschool mother of two teenagers, Melissa, values education and a life-long pursuit of learning. Her teaching style is comfortable, fun, and interactive, with an emphasis on leading the learner to have their own “light bulb” moments. As a childbirth educator and doula, Melissa most enjoys watching women become empowered to listen to their inner voice and acknowledge their own strength to birth.  Mentorship and education are both her passions, and Melissa is dedicated to fulfilling those passions by actively facilitating childbirth education classes as well as training and mentoring new doulas regularly.  Melissa can be reached at Melissa@capitalcitydoulaservices.com

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