Thursday, May 14, 2015

Everything is Accurate on the Internet, Right? Bonjour!

Watch this video:

Just Google it.

Ask Siri.

Everything you read is accurate on the internet, right?

Well not always.

Here's the straight truth:  not everyone is writing evidence-based information.  Some writers give their opinions or the opinions of others.  Some writers choose to quote sources that are out of date (the optimum number of years for research data to be significant is within 3-5 years). Other writers will quote themselves or their books, neither of which are evidence based.

When reading about birth and breastfeeding on the internet, go to the reliable sources.  These sources include PUB MED (National Institute of Health), Cochrane Database, Childbirth Connection, or any source that references within 3-5 years of the current date.

It's ok to Google It or to Ask Siri.  You just have to be able to evaluate whether the source that was found is viable. 

Tuesday, May 12, 2015

Annual Blog Carnival ~ Deadline is June 1!

Each year, Childbirth Today hosts a blog carnival!  
This year, the focus will be on Fathers!


If you would like to submit to the 2015 Childbirth Today Blog Carnival, here is the info!

A blog carnival is a themed collection of entries during a specific time period. 

Guest bloggers send their 500 word (evidence-based, referenced) submission to no later than June 1, 2015.  The context of the submission must be childbirth, with a particular focus on Fathers.

Guest bloggers must provide proof of original/or permission to use photos if photos are included with the submission. Childbirth Today and Perinatal Education Associates encourages copyright protection.

Guest bloggers should also provide a 3-5 line bio of themselves, including credentials.  The addition of the guest blogger’s contact information is highly encouraged, as sometimes readers would like to speak to you directly!

Guest bloggers can be from anywhere in the world.  Submission is not limited to the US.

Submissions may be edited for punctuation and/or grammar.

We will use the first ten blog submissions during our Blog Carnival.  Should we receive more than ten (and we have in the past!), we will continue to run the submissions until all submissions have been published.

Why would you want to submit to our Blog Carnival?

Helps you to network through social media.
Assists you in honing your writing skills.
Establishes you as a birth authority and birth blogger!
Promotes your birth-related business!

Remember, 500 words by June 1!  Now…..get writing!

Monday, May 11, 2015

10 Top ways to effect change in maternity care

In a retrospective analysis of maternity care practices in the US, much progress has been made.
However, there is still much work to do.  In spite of all of the progress, the US still ranks too high in maternal morbidity and mortality and infant morbidity and mortality.

History shows us that while the cesarean section rate and medical intervention rates rise, the risks to mothers and babies have also risen.  Therefore, it becomes an imperative for professionals to have the most updated evidence-based information to assure consumers that best practice is being achieved.

Become educated yourself.
Identify several main topics that need to be improved in your community such as VBAC rates, cesarean section rates, breastfeeding rates.  Become the expert on just a few topics, making notes of the evidence and the source of the information.  Make certain that the research is no older than 3-5 years for optimum accuracy

Understand why there may be a lack of evidence in the hands of professionals
When medical professionals finish their education, most are only required to obtain a certain number of hours of continuing education during a specified length of time.  This can be as little as 24 hours in a 3 year period.  Some even less.  So is it any wonder that once professionals leave school, they are unaware of the latest evidence?  Also realize that medical and nursing school have limited time to teach students life saving techniques.  Unfortunately, facts about physiologic birth and breastfeeding are not stressed;  in some cases, are not even addressed.

Create an environment for promoting evidence.
Once you have become educated, decide on a plan for promoting and presenting evidence.  Before this plan can be created, your target needs to be identified.  Will you present the information to professionals? Or to parents?  If you will be addressing professionals, understand how professionals learn: through presentations and workshops that carry CMEs or CEs.  These are continuing education credits recognized by physicians and nurses.  Or will you be helping parents become more educated?  Becoming a certified childbirth educator or linking up with one can increase your chances of reaching parents.

Identify resources of evidence based information
Finding the evidence is relatively easy if you have access to a computer.  Websites such as the Cochrane Database or Childbirth Connection, National Institutes of Health or March of Dimes can be great sources of information.  When reading articles, look for research that has been quoted.  Avoid op ed pieces and blogs where only opinion exists

Provide the evidence in plain language to the consumers
Most medical evidence is written in medical language that the average person may not be able to comprehend.  First, identify the educational level of the consumers that you wish to reach.  Second, translate the evidence into the language for those consumers.  Attention to literacy level and the use of appropriate photos and graphics adds to the learning process.

Provide the evidence to the medical professionals
Professionals are busy.  When providing the most up-to-date evidence based research, present the information in short bites and include the names of the journals.  Often if professionals see that their own journals are advocating for best practice based on new research, the possibility of change improves.  However, change in the medical profession is always very slow.

Use all types of social media to present the evidence
History and research demonstrates that it is the power of the consumer that changes medical care and in particular, maternity care.  During the natural childbirth movement of the 1970s, childbirth education made a huge impact on expectant parents.  Today, most expectant parents are online and frequent social media.  Present evidence-based information via all social media, using Tweets, memes, infographics, qr codes, websites and more!

Volunteer on the local, state and international level
From local Birth Networks to organizations such as the International Childbirth Education Association or Coalition for Improving Maternity Services, need volunteers to help maintain support for those who are promoting the evidence and also provide a more unified voice for best practice.

Be professional in presentationWhereas you don’t have to wear a suit or lab coat to present information to either groups, parents or professionals, you do have to present a professional appearance to garner respect.  Know the group you are working with and dress, speak and act appropriately.  If in doubt, contact a peer for an honest opinion.

Don’t give up
Many childbirth professionals become burnt out from years of advocating for physiologic birth and better birth outcomes.  History again shows us that the energy in the 60s and 70s gave way to the apathy of the 80s,  and then the high rates of interventions in the 90s and 2000s.  We cannot give up nor can we promote evidence based maternity care in the old ways.

The evidence is out there – protect it and promote it.

"Just Let Them Feed" An innovative breastfeeding video

This is not your normal breastfeeding video - it is contemporary.  It is meant to be catchy and attractive and it doesn't disappoint.  Made by the Western Arrarnta People of Ntaria, these Aboriginal women wanted to reinforce the benefits of breastfeeding and educate their community.  


Tuesday, March 31, 2015

Labor Positions and How They Work!

Are you looking for free videos to use in your teaching?  This is a nice, short video on the purpose and value of positions and changing positions during labor.   If you haven't subscribed to my YouTube Channel, "Connie Livingston", I have more there under the playlist "Childbirth Education".  Enjoy!

Monday, March 09, 2015

MTHFR: Implications for Childbirth Educators, Doulas and Lactation Consultants

MTHFR or methylenetetrahydrofolate reductaste is a gene found on a certain chromosome in every human cell.  The MTHFR gene creates an enzyme responsible for a process that changes the amino acid homocysteine to methionine, another amino acid.  Amino acids are the primary ingredients of proteins, and methionine makes proteins and other critical compounds.  A mutation of this gene can generate a disruption of the normal function of MTHFR, which breaks down the homocysteine.

Mutations are classified as heterozygous or homozygous.  If the mutation is heterozygous, the
mutation is on one strand (allele) of the chromosome. There are few if any clinical implications for those with a heterozygous mutation.  If it is homozygous, the mutation is on both strands or alleles.  It is estimated that mutations occur in 12% -17% of all humans.

High levels of homocysteine (or hyperhomocysteinemia) can cause inflammation in the body, such as to blood vessels.  High levels of homocysteine have been linked to cardiovascular disease, thrombosis, certain cancers and fractures.  Research is now focusing on severe MTHFR mutations that cause problems during pregnancy – most notably, miscarriage.  The miscarriages are produced by a clotting disorder.    There may be thyroid complications, pre-eclampsia, placental lesions and of course miscarriage.  Pregnancy complications rise 80 fold for those who have a homozygous mutation.

Just how to treat MTHFR is controversial.  Depending on the mutation, treatment can include supplementation with folate, care providers may also suggest a regimine of anti-clotting medications such as heparin or Lovenox.  While the package insert for Lovenox states that “Lovenox is not expected to harm an unborn baby.  However, some forms of this medication contain a preservative that may be harmful to a newborn.”  Much of the treatment seems dependent on the type of mutation.

To learn more about MTHFR and Pregnancy, here are some valuable websites.