Thursday, September 24, 2009

We Join CIMS in Responding to NBC

If you read my blog about NBC's segment on homebirth and midwives (NBC, ACOG and Midwives, OH MY!), a formal response from CIMS (the Coalition for Improving Maternity Services) and 45 other childbirth related organizations(including Perinatal Education Associates, ACNM, Lamaze, ICEA, MANA, and the Big Push) has been sent to NBC.

The formal response, including all of the evidence-based information and meticulous bibliography can be viewed in PDF by clicking here.

We are proud to be a part of the One Voice Response ~ an action item identified as important in the Chicago Birth Summit held in November 2008 and hosted by Perinatal Education Associates. We feel that when organizations come together in this One Voice to correct misrepresentations disseminated by the media, everyone wins.

We applaud all who spent the time crafting this response!

Getting Ready for the Lamaze Conference

Frequent conference goers will look for the bright sunflower yellow and purple table cloth that is distinctively Perinatal Education Associates/Birthsource!

This year we have some outstanding NEW products including (hot off the presses) the new book Creating & Marketing Your Birth Related Business. Both authors will be in Florida to sign these special advance copies of the book!

We also have other new books and new jewelry and aromatherapy items! Plus, Lamaze is also the debut of the first of several new breastfeeding tabletop charts! Our regular tabletops for labor/birth are so popular, we have been working with Donna Walls RN, IBCLC (former president of OLCA ~ Ohio Lactation Consultants Association) and our own graphic artist to give childbirth educators, midwives, nurses and doulas the best evidence-based breastfeeding charts available. Stop by our book and take a look at this all new chart. Better yet, purchase one!

Also at our booth is the new Onyx Birth Ball. You've seen the purple and blue ones...and yes, we'll have those too. But the Onyx one is stunning and a real eye-catcher!

So if you want to breathe some new life into your practice, stop by our booth and say hi! Remember too, if you subscribe to our newsletter Childbirth Today, there is a coupon at the bottom of the last issue!

And.......we'll be blogging, Tweeting and Facebooking from the Conference!

Monday, September 21, 2009

Thursday, September 17, 2009

5 Things Not To Say During Birth: from Dad Labs

This is the first video I have viewed from these two Dads. Kinda funny. They do seek counsel from a doula! One profane word but rather cute.

Monday, September 14, 2009

NBC, ACOG and midwives, Oh My!

The machine for mass instruction, the media (especially NBC), gets an "D-" for last week's dismally un-evidence-based coverage of birth in the U.S. The NBC interview was nearly simultaneous (September 10, 2009) with the ACOG release of their 2009 Medical Liability Survey (September 11, 2009), admitting that more than 63% of ob-gyns report making changes to their practice due to the risk or fear of liability claims or litigation; 60% have made changes to their practice because liability insurance is either unavailable or unaffordable. "

Not making changes in maternity care for the health of women and babies or because of requests.

Perhaps the definition of journalism should be changed to: the machine for selective mass instruction based on the spin to which the catalysts wishes.

Absent from NBC's report were the myriad of studies showing the safety of midwifery births and the negative outcomes of hospital-based physician centered births. Absent from the NBC report was the CDC report saying that homebirth was actually safer than hospital births. Absent was any interview from "the other side", from any midwifery group such as ACNM or others. Instead, NBC exploited the grief of a couple whose baby died due to an apparent nuchal cord. There is absolutely no denial that this is a tragic and horrific event. To exploit it, is deplorable.

Explaining that the recent surge of homebirths (nearly 27% increase in the last decade) attended by midwives is similar to going to the spa, NBC preferred to quote ACOG saying that hospitals are the safest place to give birth, rather than report on the evidence which proves otherwise. No one bothered to mention about the rise in cesarean rates (elective or "clincially indicated"), elective induction or the suspicious rise in near-term preterm infants. Additionally, no one bothered to mention the fact that many physicians discourage their patients/clients/customers from attending childbirth education classes and discourage them from using doulas.

And suspicously present was the familiar rhetoric used by ACOG in recent months in describing the message of films such as the Business of Being Born, Orgasmic Birth and Pregnant in America: a cause celebre, fashionable, and trendy: slamming natural birth, midwifery and homebirth and terming them "extreme". And coming very close to personally attacking Cara Muhlhahn, the midwife who was featured in the Business of Being Born.

NBC made several positive points: showing Marsden Wagner M.D., a couple who successfully birthed a 10 lbs at home, and repeatedly calling for discussion.

Several organizations have released statements about the NBC report:

Response from Lamaze

Response from The Big Push For Midwifery

And here is the report itself. If you choose to respond, please do so at!

Visit for Breaking News, World News, and News about the Economy

Tuesday, September 08, 2009

Monday, September 07, 2009

Happy Labor Day USA!

In honor of "Labor" Day here in the US, I found a great time lapse YouTube video of a woman's pregnancy. Found it interesting! Hope you do too!

Wednesday, September 02, 2009

The Evidence Says: Upright Position for Labor

I don't know about you, but I have been teaching upright positioning in first (and second) stage of labor for over 25 years. During the 90s and early years of this century, I saw a great retreat from autonomy during labor and birth by both women and their support partners (excluding doulas). However now, armed with research, women are staging a push back against policies, practice guides and practitioners who do not practice evidence based medicine in maternity care. I personally feel that the access of expectant parents to the evidence is credited both to the internet and to the tireless professionals who bring the evidence (in easy to understand terminology) to those parents.

Inspired by the early writings of Caldeyro-Barcia, I have continued to encourage expectant mothers change positions every 20-30 minutes to facilitate the cardinal movements of the baby. Authors now have reviewed the effects of upright positions (walking, sitting, standing, kneeling) versus recumbent positions (supine, lateral). Looking at 21 studies and totalling over 3700 women, the conclusion is that upright positioning reduces length of labor and does not seem to be associated with increased intervention or negative effects on mothers' and babies' wellbeing. In fact, these researchers feel that "women should be encouraged to take up whatever position they find more comfortable in the first stage of labor." (Cochrane Database Review April 15, 2009: Lawrence, A.; Lewis, L. ; Hofmeyr, GJ; Dowswell, T.; and Styles, C).

Similarly, a Cochrane Database Review in 2004 of 5764 participants demonstrated that upright positioning reduced the need for assisted delivery (forceps and vacuum), reduction in episiotomy and perineal tears, reduced pain during second stage of labor and fewer abnormal fetal heart rate. In November of 2008, AWHONN (The Association of Women's Health Obstetrics and Neonatal Nurses announced the release of Nursing Care and Management of the Second Stage of Labor: Evidence-Based Clinical Practice Guideline (2nd Edition). The 2nd edition of the clinical practice guideline includes updated literature sources that provide current and important evidence about the benefits of upright positioning, delayed and non-directed pushing during the second stage of labor. Use of these techniques during this critical time in labor has been shown to optimize outcomes for both the mother and her newborn. "It's vital to have the best evidence-based information available to ensure optimal care for women and their newborns during this critical period," says AWHONN Interim Executive Director, Karen Peddicord, RNC, PhD. "This guideline emphasizes the importance of educating women about and supporting them through the second state of labor. Incorporation of the guideline elements into childbirth education programs can promote consistency between what is taught about the second stage of labor and what is practiced in a clinical setting."

The evidence is in the medical literature and the nursing literature.
Let the push back continue....