Wednesday, June 24, 2015

The Circle of Maternity Care: pregnancy-birth-postpartum. Why do we keep breaking the circle?

Nearly every time I attend a maternity conference, I realize that we are STILL in crisis.  There is a huge crisis in maternity care in nearly every corner of the world.  That crisis is that we break the circle of maternity care: pregnancy-birth-postpartum.

In few cases, there is continuity of care. However for the vast majority of women, there is no continuity from preconception to breastfeeding.  The medical community continues to fiercely treat us separately: mind, body, spirit, mother, baby.  If it makes so much more sense to have this circle of caring, why don't we do it?

Preconception is virtually ignored, however a search of the medical literature demonstrates that a healthy and planned preconception period leads to healthier pregnancy outcomes. Likewise, a healthy pregnancy plan also increases the likelihood of healthier pregnancy outcomes.  As eloquently pointed out in her book "Impact of Birthing Practices on Breastfeeding", Linda J. Smith defines the ways that our birthing practices are negatively (and positively) impacting breastfeeding.  Likewise, how we treat women during pregnancy and during the postpartum period can influence their outcomes, especially for those suffering from pregnancy mood and anxiety disorders. A glitch in the system often greatly impacts the mother-baby dyad.  We cannot afford to do this to our society.

I have put the call out before, and it needs repeating.  Childbirth educators & doulas together need to lead the way in preserving the circle of care.  We need to step up our education of expectant parents.  Armed with the evidence, such as in the ICEA Position Papers, educators and doulas need to work together in our communities with lactation consultants and postpartum doulas to enhance the circle of care so that the circle is maintained and is recognized as valuable.

When women have the information, they will feel more comfortable asking for clarification. Give a list of valuable websites such as Childbirth Connection where the research has already been done and it is a reputable/research-based resource.

One person cannot alone make a change in maternity care.  But together, professionals can move to educate women so that they will be asking for information and for change!

Monday, June 22, 2015

Tuesday, June 09, 2015

What is a Strong Web Presence and Why You Might Need It

With today's expectant parents learning a vast amount of information from the web, it may be important to you in your segment of the birth profession to have a strong web presence.  But what exactly is a web presence and how do you achieve or strengthen one?
A web presence is defined on Wikipedia as being "the appearance of a person or organization on the World Wide Web." And "the amount of web presence can be measured in the amount of sites a organization or individual has, which can include their own website, social network profiles, and their site's search engine ranking, traffic, popularity, and backlinks.
Having a presence on the web is more than updating Facebook or sending out an occasional Tweet. And it is more than Search Engine Optimization or SEO. Its about who you are, where you are on the web, how evidence-based your content is and how it relates to the birth profession.
When I first built back in 1999, the very first thing that I did was complement others on their web design or content and ask for backlinks.  This immediately increased the traffic to the Birthsource and increased the popularity.
Step two in building a presence was to have the most up-to-date evidence based information to both parents and professionals.  I wanted a website that served both demographics - educating the educator and the expectant parent.  Simultaneously to this was my work at doula and childbirth education training.  Due to the requests for certain teaching tools from the workshop attendees, the online store was born in 2001.
In 2007, I decided to try blogging and became slightly addicted!  So in that year, Childbirth Today (the blog you are reading now), was created to give a different view on information, share new or interesting videos and invite guest writers to try their hand at blogging.
After teaching one of the best childbirth classes of my career in 2008, the next step in web presence came along: A second website.  I say that this was one of the best classes because the dynamics of the class and the personality of the attendees was so amazing that I am still in touch with most of the class members.  I am now watching most of these "babies" entering kindergarten, thanks to Facebook!  But I digress.  The new website was really at the request of one expectant mom in the class.  She was frustrated because there was not a straightforward website with research information.  The Birth Facts came online in late 2008.
After exhibiting at conferences for nearly 10 years, I joined Facebook also in 2008.  Posting a blend of personal quirkiness (my love of grande decaf peppermint mochas and adventures with my family) and evidence-based women's health news stories, Facebook has been a vital step in a strong web presence.  Add to that a Facebook account for my business, a Twitter account (@birthsourcecom), LinkedIn, Pinterest, Instagram and the use of memes, I have expanded my reach to expectant parents and professionals exponentially. 
Some companies have a person specifically assigned to the duty of managing a web presence the web presence manager. Because I'd rather do this job myself, I enlisted the aid of my laptop, iPhone and iPad to achieve these goals:
Friends on Facebook: (to date) 2912
Followed by on Twitter: 1959 with 4,987 Tweets made
Estimated visitors per week to blog: 500-800
Visitors per week to Birthsource website: 1000
Embracing technology has enabled me to teach more individuals than I ever could in a classroom.  Reaching out on social media not only means introducing new concepts, but also reinforcing the validity of established concepts.  To quote Phyllis Klaus, we must "meet the mother where she is and take her where she wants to go".  And what better way to help her get to her goals than via social media?

Tuesday, June 02, 2015

Do We Really Need Another Childbirth Revolution?

The answer from Des Moines Register reporter, Rekha Basu, is yes.

Citing the late Elizabeth Bing’s  and Sheila Kitzinger’s monumental contributions to maternity care, Basu states that with the cesarean birth rate up 500% since 1970 and our infant death rate higher than most countries, fear and lack of education seems to be the causes.

Like the obstetrical community, the media is slow to change.  But with this article, dated May
30, at least the media seems willing to listen.

The World Health Organization states that 85% of the time, birth is an uncomplicated life event.  Only 15% of births truly are in need of a cesarean birth.  Cesareans are responsible for saving countless lives, both mothers and babies.  However, when Consumer Reports published, “The Risks of C-sections: What hospitals don’t want you to know” in February 2015, people sat up and took notice.

According to the Consumer Reports article, “In the U.S. far fewer babies are born on holidays such as the Fourth of July or days around Thanksgiving or Christmas, we found when we examined three year's worth of data on births compiled for us by the Centers for Disease Control and Prevention. That could be because hospitals tend to schedule C-sections for times when they are well staffed—or because doctors, and even some mothers, may not want deliveries to interrupt their holidays. That level of control requires increased use of interventions such as inducing, or starting, labor before a woman’s due date, which might increase the risk of cesarean delivery, or just scheduling a C-section from the start.”
With other new articles being published, new ACOG Guidelines, and childbirth organizations such as ICEA, Lamaze International and Childbirth Connection speaking out, both professionals and parents have a lot of quality information at their fingertips.  For example, hospitals around the country are examining their cesarean rate and making changes.  One of the leaders in this effort to reducing unnecessary cesareans is Denver Health Medical Center, where the cesarean rate is 7.9% (the estimated US cesarean rate is 32.8%).  Firm policies about the use of interventions that could cascade into a cesarean situation and an active midwifery care are two of the implementations DHMC has undergone.
So does the US need another childbirth revolution?
I think we are in the midst of one.  While it is slow moving, there are many things professionals can do to facilitate such a revolution:
Childbirth educators should:
Commit to teaching an evidence-based curriculum.
Make online resources available for the new parents in the classes.
Update current knowledge by becoming active in their certifying organization and attend an annual conference.
Labor and delivery nurses should:
Advocate for 1-1 nursing care of laboring moms.
Embrace doulas to assist in the physical and informational support.
Attend workshops that focus on non-pharmacologic pain relief skills.
Parents should:
Seek out certified childbirth educators for classes.
Be selective and interview their care providers, physicians and midwives.

Create birth plans that demonstrate forethought and education.

Yes, the answer is YES!

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.