Monday, December 15, 2014

Ending Pain in Pregnancy

Ending Pain in Pregnancy by Isa Herrera MSPT, CSCS is a common sense approach to common problems, including symphysis pubic dysfunction, sciatica, and diastasis recti.  For too long, women have been told that pain in pregnancy is "all in their heads" or "it can't be that bad". Many pregnant women suffer their entire pregnancy without relief or compassion.

Herrera operates Renew Physical Therapy in New York City and has dedicated her career to helping women find relief from painful pelvic conditions.

Beginning at the beginning, Herrera discusses anatomy and physiology along with proper body mechanics - the foundations of pain reduction or pain elimination.  In depth, she discusses the change in a woman's body during pregnancy and how the hormones can soften cartilage - affection the pelvic bones.  With careful detail, Herrera explores the causes and symptoms of pain in pregnancy and helps the reader develop a personalized plan.  

She also covers pelvic floor muscles, their function and the importance of Kegel exercises - a topic currently under scrutiny.  In a way that makes sense, Herrera also describes perineal massage, both
with words and clear illustrations.  This is by far the most extensive explanation of Kegels and perineal massage I have ever seen.

Positions to relieve pregnancy pain as well as pain in labor are covered in the traditional sense, but also in modified forms to aid women with orthopedic, spinal or pelvic conditions.  Non-pharmacologic pain relief methods and their inclusion in birth plans rounds out the labor and birth sections. Click here for Labor Positions Chart

To be thorough, Herrera also includes postpartum information.

This is more than a how-to book to be pain free.  It is a dynamic book that encourages health maintenance along with solving problems.  Herrera's common sense approach makes this the perfect book for any expectant woman as well as any doula, childbirth educator, midwife or Labor/Delivery nurse.

More women experience these types of pain during pregnancy than may ever vocalize.  Care providers need to once again be well-versed in the ways to eliminate pain and enable women to take educated control of their bodies.  But this book doesn't only address the physical aspects of pain in pregnancy - it goes a step farther and incorporates relaxation, visualization, meditation, mindfulness and breathing - making this an extraordinary valuable book. 

Available from Amazon:
Paperback    $26.59
Kindle          $23.99

481 pages
ISBN: 9780692237212 

Monday, December 08, 2014

What is the National Perinatal Task Force and How Can You Help?

The National Perinatal Task Force has been visible on Facebook, but you may be wondering what it is .  Here is a video Google Hangout done a few weeks ago, explaining the goals of the National Perinatal Task Force.

Monday, December 01, 2014

Five Tips for Staying Healthier This Holiday Season!

Whether you are a nurse, midwife, physician, childbirth educator, doula or lactation consultant....OR if you are forwarding this to someone who is pregnant, these five tips for staying healthier this holiday season are for you!

Stay hydrated

Oddly, winter is an ideal time to become dehydrated whether pregnant or not.  The increase in
caffeinated beverages with their diuretic effect can contribute.  You still need to consume 6-8, 8 oz glasses of water (not tea or coffee or soda) daily.  That is 64 fl oz or 1/2 gallon or more. Mild to moderate symptoms of dehydration in adults include an increased thirst, dry mouth, tired or sleepy, decreased urine output, urine in low volume and more yellowish than normal, headache, dry skin, dizziness, and few or no tears.  Still not sure if you are in need of more fluids?  Check out this info graphic from the Cleveland Clinic on what the color of your urine says!

Eat wisely

As you may have noticed in the recent US holiday of Thanksgiving, it is quite easy to depart from your normal eating patterns.  In remembering this, challenge yourself to replace breads and pies with veggies and fruit - you still need 6-10 servings of fruits and vegetables even during the holidays.  Refrain from red meats or meats that have been raised with hormones and antibiotics.  Begin the day with a good breakfast.  And perhaps finish the day off with some dark red cherries as they stimulate the production of melatonin - so you can do the following --->

Pay attention to your Circadian Rhythm

What is your Circadian Rhythm?  Defined by the Center for Sleep Medicine near Chicago Illinois, The term, "Circadian Rhythm" refers to our body's internal clock which regulates the timing of such body rhythms as temperature, hormone levels, metabolism, and most visibly the sleep-wake cycle. The clock is set in relation to the changing light and dark cycles of our planet and relies on "Zeitgebers" - cues which influence the clock's timing. Exposure to light and darkness the most important cues, but so are other functions, such as eating and exercise. The circadian clock functions in a cycle of approximately 24 hours. Our circadian clock is controlled by an area of the brain called the Suprachiasmic Nucleus (SCN). Exposure to light and darkness - which regulates the circadian clock - is communicated along a pathway from the eyes to the brain.  Age, genetics and hormones do pay a part in getting rest but listening to your body when you are tired, which may mean sleeping more during the winter (hibernation) leads to less weight gain, improved mood and an increased ability to concentrate!

Get at least 8 hugs a day

The website recommends at least 8 hugs per day because:

(1) The nurturing touch of a hug builds trust and a sense of safety. This helps with open and
honest communication. (
2) Hugs can instantly boost oxytocin levels, which heal feelings of loneliness, isolation, and anger. (3) Holding a hug for an extended time lifts one's serotonin levels, elevating mood and creating happiness. (4) Hugs strengthen the immune system. The gentle pressure on the sternum and the emotional charge this creates activates the Solar Plexus Chakra. This stimulates the thymus gland, which regulates and balances the body's production of white blood cells, which keep you healthy and disease free. (5) Hugging boosts self-esteem. From the time we're born our family's touch shows us that we're loved and special. The associations of self-worth and tactile sensations from our early years are still imbedded in our nervous system as adults. The cuddles we received from our Mom and Dad while growing up remain imprinted at a cellular level, and hugs remind us at a somatic level of that. Hugs, therefore, connect us to our ability to self-love. (6)Hugging relaxes muscles. Hugs release tension in the body. Hugs can take away pain; they soothe aches by increasing circulation into the soft tissues. (7) Hugs balance out the nervous system. The galvanic skin response of someone receiving and giving a hug shows a change in skin conductance. The effect in moisture and electricity in the skin suggests a more balanced state in the nervous system - parasympathetic. (8) Hugs teach us how to give and receive. There is equal value in receiving and being receptive to warmth, as to giving and sharing. Hugs educate us how love flows both ways. (9) Hugs are so much like meditation and laughter. They teach us to let go and be present in the moment. They encourage us to flow with the energy of life. Hugs get you out of your circular thinking patterns and connect you with your heart and your feelings and your breath. (10) The energy exchange between the people hugging is an investment in the relationship. It encourages empathy and understanding.
Practice mindfulness daily

According to an article published by the Northern Arizona University, there are five key ways that mindfulness increased physical and mental health:  it strengthens the immune system and physiological responses to stress and negative emotions; it improves social relationships with family and strangers; it reduces stress, depression and anxiety and increases well-being and happiness; it increases openness to experience, conscientiousness and agreeableness and reduces negative associations with neuroticism; it leads to greater psychological mindfulness, which includes an awareness that is clear, nonconceptual and flexible - a practical stance toward reality and present attention to the individual's consciousness and awareness.

Monday, November 24, 2014

Birth Rocks Academy in UK

In case you missed it over the weekend, here is the link to the interview I did for Birth Rocks Academy in the UK.

Click here to read the interview.

Thursday, November 20, 2014

Obstetric Violence & Human Rights - Dr. Amali Lokugamage

I invite you to listen/view Dr. Lokugamage's lecture.  It may be the most important 15 minute video you watch this year!


Tuesday, November 18, 2014

Tips When Writing Behavioral Objectives

As a nurse, midwife, childbirth educator or doula, you may be asked to write behavioral objectives for a new program or when you become a speaker at a workshop, seminar or conference.  I have put together some helpful tips for writing these objectives.

Behavioral objectives, learning objectives, instructional objectives, and performance objectives are terms that refer to descriptions of observable student behavior or performance that are used to make judgments about learning. Whether you are a childbirth educator, doula, nurse, lactation educator or trainer, at some point you will be asked to write behavioral objectives.

While some feel that writing behavioral objectives is a waste of time, it is generally felt that using behavioral objectives allows the educator to actually see what will be covered during a specific time period and not to overwhelm the student. Using objectives help to clarify what details to include under what generalized topic area, plus allows for examination of the order in which topics and details will fall. Further, using behavioral objectives promotes creativity with
the educator when developing teaching strategies for use with all learner types.

The three parts of a behavioral objective are:

1.Conditions (a statement that describes the conditions under which the behavior is to be performed).

Behavioral objectives are about curriculum, not instruction. Therefore, the list of objectives may be preceded by the phrase, "At the end of this session, participants will be able to…"
2. Behavioral Verb (an action word that connotes an observable student behavior).
Behavioral verbs for use with curricula or CE (or continuing education unit) forms are typically upper level verbs and include classify, construct, define, demonstrate, describe, diagram, distinguish, estimate, evaluate, explain, identify, interpret, label, list, locate, measure, name, order, predict, reproduce, solve, translate.
See this link for Blooms Taxonomy and measurable behavioral verbs.  Click here.
3. Criteria (a statement that specifies how well the student must perform the behavior).
Behavioral objectives are measurable (note the four below), which means that the objective can be turned into a test question or evaluation item at a later date.

So, for someone who is writing a curriculum to include the topic of comfort measures for use during labor, a measurable behavioral objective might be:

At the end of this session, participants will be able to:

List four comfort measures that can be used during labor.

When developing a curriculum and writing objectives, it may be useful to use a format where the objectives, outline of the content, time frame and teaching strategies can be viewed simultaneously.

Most professional documents require references written in the APA Style.  APA (American Psychological Association) is most commonly used to cite sources within the social sciences. This resource, Purdue University, revised according to the 6th edition of the APA manual, offers examples for the general format of APA research papers, in-text citations, endnotes/footnotes, and the reference page. 

Friday, November 07, 2014

Not all birth advocacy comes from the usual suspects!

Meet Top RN to BSN: Your guide to the best RN to BSN programs.  This website serves all nurses and nurses to be with the means to find BSN programs and also do some education.  I was contacted by the website’s Linda Harris.  RN to BSN has created an infographic – Bringing Birth Back: The Rise of Cesareans and the Movement to Safely Prevent Them.

The infographic has contains the latest evidence-based information including the newest  US cesarean rate percentages and the WHO studies that mention a recommended percentage of 10-15%.  The complications for both mother and baby are examined, although missing is information such as the grieving process many mothers go through after having a cesarean birth and the dangers of cesareans for future generations by changing the epigenetics.   The infographic mentions “how we got there” and hints at elective cesareans on the part of doctors and women, as well as the threat of litigation.  There is even a state by state graphic which correctly lists hospital cesarean rates from 7%-70%.

The graphic does include the “6 cm is the new 4cm” information and cautions against early diagnosis of labor arrest.  Induction timing is also a focus, referring somewhat to the “Go the full 40 weeks”.  One of the biggest positives of the graphic is the attention to VBACS and the effects of (birth and postpartum) doula care.

While I understand that an infographic is a short snapshot of time, I do wish they had included the emotions ~ grieving and possible links to postpartum depression.  While the resources include the CDC, ACOG, DONA , March of Dimes, and Childbirth Connection,  a reference to the importance of childbirth education and the role it can play in cesarean prevention would have been nice.  The only reference to childbirth education came as a quote from then Lamaze International President Michele Ondeck, siting the ACOG recommended practice changes as “This is a Game Changer”. 

Truly, infographics are in the future of education.  Like handouts, infographics can be disseminated to a larger audience of individuals and create on-the-spot learning.  I applaud for educating nursing students.  This is one area where childbirth educators need to focus on for implementation of best practice.

Check out the infographic for yourself:

Bringing Birth Back