tag:blogger.com,1999:blog-388839092024-03-13T14:15:43.187-07:00Childbirth TodayOfficial Blog of Connie Livingston and Perinatal Education Associates, Inc.Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.comBlogger596125tag:blogger.com,1999:blog-38883909.post-63881489185415680872016-12-05T15:29:00.000-08:002016-12-05T15:29:24.203-08:00<b style="font-family: arial, helvetica, sans-serif; font-size: small;"><i><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">I'm continuing to review some of the most talked about topics of 2016. In the next few blogs, titled "Year in Review", I will share findings, thoughts and resources for you, the birth professional, as well as resources for your clients. If there is a topic you would like to see in "Year in Review" please email me at info@birthsource.com.</span></i></b><br />
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<b><span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Birth
Doula/Postpartum Doula Care<o:p></o:p></span></span></b></div>
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<span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Doula care worldwide is increasing in popularity, where
popularity is both defined as public knowledge of the word and its meaning, and
also the access and use of doula care both in the birthing process and in
postpartum. After nearly 35 years of
research, this is a welcomed statement to make.
Current research in journals, particularly nursing journals (AWHONN),
demonstrate the definite benefits to the laboring family and care providing
team of </span></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>birth doulas</b>. From reducing the
cesarean section rate through non-pharmacologic pain relief methods and the
integration of upright/gravity positive frequent position changes, doulas
provide the 1-1 care that (especially in the US) maternity medical care so
frequently talks about, richly needs and from which huge benefits can be
derived.<o:p></o:p></span><br />
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<span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>Postpartum doula care</b> has been attributed to extended
breastfeeding, easing of postpartum mood and anxiety disorders and an overall
reduction of stress brought about by new parenthood. With immediate and extension of breastfeeding
comes better health for the new society being born, and a healthier society for
tomorrow. Postpartum doulas care today
for the health of the community of the future.
This may prove to have significant effects on future health care
studies.<o:p></o:p></span></span></div>
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<span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">One overall drawback to doula care is the lack of
standardization in training and certification.
There are currently a myriad of nonprofit organizations, startup
companies and small businesses who provide doula training and
certification. It is the opinion of this
author that a standard, professional training and certification module would
greatly enhance the acceptance of doulas as members of the health care team
(much like nursing) as well as increase credibility in the lay community. Standardization would also help eliminate the
person who enters the profession of doula care with their own agenda. Regretfully, these hidden agendas are brought
forth after training and certification are complete and when the doula begins
practice in their community. It is then
that negative agendas appear and the entire doula community may be labeled
according to one doula’s rogue agenda.
This can happen in any segment of the medical community, however, if the
doula is not an employee of a hospital or birth center, or not a member of an
organization with a grievance policy, there is precious little that can be done
to “save face” after an act has been completed.
Knowing the lengths that some individuals would go to promote their own
agendas, this author sometimes doubts that a threat of suspension or withdrawal
of standard certification or even licensure would thwart a doula’s rogue
agenda. We don’t know until we try.<o:p></o:p></span></span></div>
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<b><span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Community
based/hospital paid/volunteer<o:p></o:p></span></span></b></div>
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<span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">There are currently several ways to access doula
care. Doulas may be independent small
business owners and operate within the community in which they live. Most of their business is referral by “word
of mouth” or perhaps low cost marketing such as business cards or
self-generated brochures or flyers. Cost
of <b>community based doulas</b> generally vary with services provided, community cost
of living, and years of experience of the doula. Community based doulas may or not be trained
by legitimate organizations, and may or may not even be certified. Community based doulas may or may not carry their
own malpractice insurance. The thinking
is that since the doula performs no clinical skill, the chances of them being
included in a law suit are minimal. To
be on the safe side and to protect their personal and professional assets, some
community based doulas do carry malpractice insurance. Clients pay the doula directly, either by
cash, credit card or even barter. The
doula is solely responsible for their own taxes. (Discussion of the decision to
be certified has been addressed in an earlier blog: </span></span><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><a href="http://childbirthtoday.blogspot.com/2016/11/certification-as-childbirth-educator-or.html">http://childbirthtoday.blogspot.com/2016/11/certification-as-childbirth-educator-or.html</a> </span><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"> )</span></div>
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<span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">More and more hospitals are bringing in doulas into their
staff. Generally, hospital based doulas
are trained and certified by legitimate organizations, overseen by a doula
director or manager, and evaluated year.
They may be included in the malpractice insurance of the hospital and
should there be a grievance against them either by a co-worker or client, the
doula director or manager would be the one to handle the grievance issue. Payment to the doula is made by the hospital
and general is a flat fee for service.
This service may include 1-2 prenatal visits, the length of labor, and
1-2 postpartum visits. Clients pay the
hospital in advance and the hospital is responsible for all taxes and fees, as
in any other business.<o:p></o:p></span></span></div>
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<span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Occasionally, a hospital based doula program can provide
<b>volunteer doulas</b> for those in a specific population (for example, if they are
conducting a trial to reduce cesarean rates in a given population) or if they
are grant funded for a specific population. Volunteers may be asked to serve as
doulas for a number of births in exchange for their training and certification. Since training and certification through a
reputable organization can cost upwardly of $500-$1200, this can be a win-win
for a hospital serving a low-income population while also giving a new career
to a person who would otherwise not be able to afford such quality training and
certification! This can also be a huge
benefit for the community, as more and more doulas are brought in to the
community for support.<o:p></o:p></span></span></div>
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<b><span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Nurse
labor support skills<o:p></o:p></span></span></b></div>
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<span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Much has been published in the nursing literature about
nurses being the perfect labor support person.
Who better to support the laboring mother and her family than the nurse
who also has intimate knowledge of this woman’s medical condition. Nurses are by definition caring and loving
individuals. It just makes good common
sense. It makes good common sense until
you realize all of the other mandatory tasks that a staff nurse in L & D
has on her plate on any given day. Not
only is she given 1-3 actively laboring patients, but there may also be a
myriad of other non-patient related tasks (such as crash cart audits). Today, nurses are also required to actively
chart electronically on each patient.
This may be an easy task for those who are tech savvy, and quite the
challenge for who are not technologically oriented. All of this makes for nurses who are
stretched emotionally and physically.<o:p></o:p></span></span></div>
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<span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">However, for those facilities who wish to give their
nurses the non-pharmacologic pain relief knowledge to support physiologic births
that is not taught in nursing school, organizations such as ICEA have special,
one-day workshops (complete with nursing CEs) to provide this knowledge. <b> ICEA’s Mother Friendly, Evidence-based Labor
Support Skills Workshop</b> for nurses is a prime example of meeting the nurses’
needs almost before the nurse knew she had the need. In this eight hour workshop, nurses not only
learn the non-pharmacologic skills but also the science and rationale behind
these skills. Nurses can go back to
their units and immediately apply their new skills ~ increasing nurse
satisfaction, patient satisfaction and improve labor/birth outcomes!<o:p></o:p></span></span></div>
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<span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Doulas still are the best way to provide physical,
informational, emotional and practical support to expectant families with
positive, statistic changing results.
Research has shown that doulas can positively impact length of labor,
perception of pain, and reduced the incidence of interventions such as cesarean
section. </span></span></div>
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<span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;"><b>In the wise words of the late
Dr. John Kennell, </b></span></span></div>
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<span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;"><b>“If a doula were a drug, it would be unethical not to use it.”</b><span style="font-size: x-small;"><o:p></o:p></span></span></span></div>
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<b><span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><u>For
Further Review</u><o:p></o:p></span></span></b></div>
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<ol>
<li><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Aschenbrenner, A.P. et
al. (2016) Nurses' Own Birth Experiences Influence Labor Support Attitudes and
Behaviors. <i>Journal of Obstetrics, Gynecology
and Neonatal Nursing</i>. Jul-Aug;45(4):491-501. doi:
10.1016/j.jogn.2016.02.014.</span></li>
<li><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Fortier, J. H., & Godwin, M. (2015).
Doula support compared with standard care: Meta-analysis of the effects on the
rate of medical interventions during labour for low-risk women delivering at
term.<span class="apple-converted-space"> </span><i>Canadian Family
Physician</i>,<span class="apple-converted-space"> </span><i>61</i>(6),
e284–e292.</span></li>
<li><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Kozhimannil, K. B. et al. (2013). Doula Care, Birth Outcomes, and Costs
Among Medicaid Beneficiaries.<span class="apple-converted-space"> </span><i>American
Journal of Public Health</i>,<span class="apple-converted-space"> </span><i>103</i>(4),
e113–e121. <span style="background-color: transparent; line-height: 115%;"><a href="http://doi.org/10.2105/AJPH.2012.301201"><span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; color: windowtext;">http://doi.org/10.2105/AJPH.2012.301201</span></a></span></span></li>
<li><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Kozhimannil, K.B. et
al. (2016) Modeling the Cost-Effectiveness of Doula Care Associated with Reductions
in Preterm Birth and Cesarean Delivery. <i><a href="https://www.ncbi.nlm.nih.gov/pubmed/26762249" title="Birth (Berkeley, Calif.)."><span style="color: windowtext;">Birth.</span></a></i><i> </i>Mar;43(1):20-7. doi: 10.1111/birt.12218.</span></li>
<li><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Kozhimannil, K.B. et
al. (2014) Potential benefits of
increased access to doula support during childbirth. <i><a href="https://www.ncbi.nlm.nih.gov/pubmed/25295797" title="The American journal of managed care."><span style="color: windowtext; mso-fareast-font-family: "Times New Roman"; text-decoration: none; text-underline: none;">American</span></a></i><i> Journal of
Managed Care. </i>Aug 1;20(8):e340-52.</span></li>
<li><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Kozhimannil, K.B. et al. (2016) Disrupting the Pathways of
Social Determinants of Health: Doula Support During Pregnancy and Childbirth. <i>Journal of the American Board of Family
Medicine. </i> Vol 29. No 3. 308-317. Doi:
10.3122/jabfm.2016.03.150300.</span></li>
<li><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Roth, L. M. (2016) North
American Nurses' and Doulas' Views of Each Other<i> Journal of Obstetrics, Gynecology and Neonatal Nursing</i>. Nov - Dec;45(6):790-800. doi:
10.1016/j.jogn.2016.06.011.</span></li>
<li><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Zielinski, R.E. et al
(2016) The Value of the Maternity Care Team in the Promotion of Physiologic
Birth. <i>Journal
of Obstetrics, Gynecology and Neonatal Nursing</i>. Mar-Apr;45(2):276-84. doi: 10.1016/j.jogn.2015.12.009.</span></li>
</ol>
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Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-54732968455116711662016-11-21T08:27:00.002-08:002016-11-21T08:27:34.959-08:00Year in Review: Elective Induction of Labor<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b><i>Today I begin a review of the most talked about topics of 2016. In the next few blogs, titled "Year in Review", I will share findings, thoughts and resources for you, the birth professional, as well as resources for your clients. If there is a topic you would like to see in "Year in Review" please email me at info@birthsource.com.</i></b></span><br />
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<a href="https://3.bp.blogspot.com/-MXkv864edd4/WDMf4Kb0vAI/AAAAAAAADYo/tYkN6HcBBs0y2IoO2GVpe52zCH52JLRmACLcB/s1600/year%2Bin%2Breview%2Bimage%2Bchef.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="190" src="https://3.bp.blogspot.com/-MXkv864edd4/WDMf4Kb0vAI/AAAAAAAADYo/tYkN6HcBBs0y2IoO2GVpe52zCH52JLRmACLcB/s200/year%2Bin%2Breview%2Bimage%2Bchef.JPG" width="200" /></a><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">In May of 2016, attendees at the ACOG annual meeting
participating in a stimulating debate on elective induction at 39 weeks. Points were made that fetal macrosomia
increases after 39 weeks which can increase the incidence of should dystocia
and increase the risk of cesarean section.
Induction at 39 weeks could potentially reduce all of those risks, but
admittedly, induction could be associated with a higher rate of cesarean. Errol Norwitz, chair of the Department of
OB/GYN and professor at Tufts University of School of Medicine, made the now
famous comment, “My position is 39 weeks and out!” He additionally said in the
Washington Post, “Nature is a terrible obstetrician.”<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">On the other side of this issue is, among others, Rebecca
Dekker, who has her doctorate in nursing and is founder and writes for the
blog, Evidence Based Birth. Dekker is
quick to shine light on the flaws in the research plus cautions about public
complacency about inductions. Inductions
are not benign, simple or non-invasive.
Some of the medications used for induction, Pitocin or Cytotec, can
create contractions that are too frequent, very painful, and can increase the
risk of restricted blood flow and oxygen to the baby.<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Still other questions need to be asked.<o:p></o:p></span></div>
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<i><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">What part does a woman’s
due dates play in the scenario? Are we
absolutely certain that dates are accurate? And based on those dates, elective
inductions are made. The answer here is
there are no absolutes on the due date, which should actually be called Due
Zones. Neonates are still maturing in
the uterus, the optimum place for growth and maturity.<o:p></o:p></span></i></div>
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<i><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Studies show that
cesarean section risk rises when the Bishop Score is 7 or less. Is the Bishop Score being taught by
childbirth educators or doulas?<o:p></o:p></span></i></div>
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<i><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">What happens with the
American Board of Internal Medicine/Association of Women’s Health, Obstetric,
and Neonatal Nurses “Choosing Wisely” Campaign?
Being certain that patients have a clear understanding (for informed
decision making) of the process of induction “don’t promote induction or augmentation
of labor and don’t induce or augment labor without a medical indication;
spontaneous labor is safest for woman and infant, with benefits that improve
safety and promote short- and long-term maternal and infant health.<o:p></o:p></span></i></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">The question still remains, in the situation where there is
no indication of clinical risk, should the pregnancy continue until labor
begins on its own, or should care providers take prophylactic measures to end
the pregnancy before there are complications?
If the latter is the case, then full disclosure for clear and complete
shared decision making must be completed.
Women must know the risks and the benefits of maintaining the pregnancy
and of elective induction. Scare tactics
based on the discomfort that care providers may have about waiting for labor to
begin on its own has no place in the shared decision making process. <o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">This is not a simple question to answer and one that must be
given careful consideration. In the
Listening to Mothers Survey II, of the women in that sample (over 600) who experienced
a medical (vs. self-initiated) induction, 25% gave the reason that their care provider was
“concerned that they were overdue,” while only 19% had a medical indication. Then
17% reported that their induction was due to the care provider having concerns
about the size of the baby.<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">We must be cautious about early elective induction and the
complications for both mother and baby.
Admitting preemies to the NICU due to “failure to wait” causes its own
cavalcade of risks. <o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b><u>For further review:</u></b><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">ACOG Committee Opinion 561 Non-medically Indicated
Early-Term Deliveries, Reaffirmed 2015.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><a href="http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Nonmedically-Indicated-Early-Term-Deliveries">http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Nonmedically-Indicated-Early-Term-Deliveries</a>
<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">AWHONN Position Paper on Non-Medically Indicated Induction
and Augmentation of Labor<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><a href="http://www.jognn.org/article/S0884-2175(15)31585-9/abstract?utm_source=awhonn.org">http://www.jognn.org/article/S0884-2175(15)31585-9/abstract?utm_source=awhonn.org</a>
<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Evidence on Inducing Labor for Going Past the Due Date by
Rebecca Dekker (Evidence Based Birth)<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><a href="http://evidencebasedbirth.com/evidence-on-inducing-labor-for-going-past-your-due-date-post/">http://evidencebasedbirth.com/evidence-on-inducing-labor-for-going-past-your-due-date-post/</a>
<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Major Survey Findings of Listening to Mothers III: Pregnancy
and Birth.<o:p></o:p></span></div>
<br />
<div class="MsoNormal">
<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3894594/"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3894594/</span></a>
<o:p></o:p></div>
Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-28179254191416267022016-11-14T10:21:00.000-08:002016-11-14T10:24:22.976-08:00Certification as a Childbirth Educator or Doula – Yes or No?<div class="MsoNormal">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">There is much controversy around training and certification as a
childbirth educator and doula. Which
organization shall I choose? Is
certification even necessary? Will
certification make a different to my clients?
How will certification benefit me?<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">All of these very legitimate questions need to be answered one by
one by the individual. In choosing an
organization through which to become certified, it is important to thoroughly
investigate the organizations being considered.
Ask the following questions:<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
</div>
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">How long has this organization been established?</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Does the mission and vision of the
organization fit with your personal philosophy?</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Is it an organization, a 501c3
non-profit, or for profit company?</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Does the organization have as its
foundation evidence-based information?</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">What is the process of certification,
including fee structure?</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">If this is a membership organization,
what are the member benefits?</span></li>
</ul>
<br />
<div class="MsoNormal">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Once you have decided on an organization with which to align
yourself, accessing the benefits of certification to you is vital. Certification indicates to your clients and
colleagues that you have cared enough to go the extra steps to read, learn, and
take the exam for certification. This
puts you ahead of those not seeking certification – not every person is a
natural teacher or labor support assistant and training and certification gives
you that edge. Along with certification
comes recertification and the need to attain continuing education. If a person is not certified, there is no
compelling reason to learn new things.
They can become stagnate and dull, teaching outdated with materials and
information.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">In the US, there is no
standardized training, certification or licensing for childbirth education as
there is for nursing. Individual hospitals or birth centers may have
their own policies that dictate who teaches expectant families. For
example, a hospital may mandate that only certified childbirth educators teach
the childbirth classes and only lactation consultants can teach breastfeeding
classes. On the other hand, some facilities do not require that
their childbirth educators be certified; the only requirement is that they are
nurses. However, nursing schools are typically not teaching how to
teach, therefore an increasing number of nurses (and non-nurses who wish to
teach) seek out programs that can teach them how to teach the information for a
variety of teen and adult learners. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Some
organizations or programs take those with little or no maternal/child health
background and provide a rigorous path of external reading, observation of
other educators, workshops, and other educational work. Other
organizations and programs require a certain level of expertise prior to entry
into their paths of study, such as labor/delivery nursing experience,
midwifery, doula training or similar experience.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Affiliation
and/or certification by an organization often carries with it adherence to an
established Scope of Practice. A scope
of practice for childbirth education or doula work can indicate boundaries or
limitations set by that organization, often with evidence-based information to
back up those boundaries or limitations. Again,
there is no standardization. So no, technically, one does not have to
be trained or certified. However, it is common for expectant parents
to ask for background training and certification – it shows a commitment to the
professionalism of the field. Additionally, nurses who have been teaching
from a set childbirth education curriculum find training and certification
exciting for themselves and they then share this excitement and enthusiasm with
their students. This increases “patient satisfaction” and increases
popularity of the hospital or birth center programs.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Doulas may or may
not choose to become certified due to initial outlay of cost. However, being able to advertise that you are
a certified doula with a certain organization does raise awareness of the level
of expertise and quality of labor support.
While many certification programs for both doulas and childbirth
educators may include in-person workshops (2-4 days in length), many
organizations now are piloting online training workshops that can be done in
the comfort of one’s own home. This not
only saves time, travel but also money on the peripheral expenses associated
with training. Along with online
training may come an offer of mentoring, which can truly help bridge the
educational gap between in-person workshops and online offerings. These online training opportunities are also
attractive to those living in remote areas, countries other than the US, and in
areas not typically served by in-person workshops. While online offerings may not be the
preferred method of learning for some individuals, it can certainly increase
the number of childbirth educators and doulas, and thus increase the
information and support to expectant families around the globe.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Below is a table
that can be used as a summary of what has been presented in this blog. The ultimate decision is up to you. Want to compare childbirth education certifications? <a href="http://www.birthsource.com/pdffiles/Childbirtheducationcomparison.pdf">Click here.</a><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 1184;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;">
<b><span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Certification<o:p></o:p></span></b></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;">
<b><span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">No Certification<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Specific, targeted learning<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Yes<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">No<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Cost for starting to teach<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Yes, training<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">No<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Adherence to Scope of Practice<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Maybe<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">No<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Benefit of aligning with recognized
organization<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Yes<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">No<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Recognition by other birth professionals<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Yes<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Possible<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Recognition by clients<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Yes<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Possible<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Membership $ for organization<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Yes<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">No<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Need for recertification<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Yes<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">No<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Need for regular continuing
education (CE)<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Yes<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">No<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Support from organization<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Yes, perhaps<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">No<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Access to specific CE<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Yes, perhaps<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 159.6pt;" valign="top" width="213"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Possible<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<br />
<div class="MsoNormal">
<br /></div>
Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-59953749505829907402016-11-07T10:34:00.000-08:002016-11-07T10:34:10.991-08:00What is Informed Decision Making?<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">One of the main constructs on which I have based my entire
career, is informed decision making or informed consent. What that means to me as a nurse, childbirth
educator and doula is that I will, to the best of my ability, give to my
client(s) understandable, current, accurate evidence-based information on a
variety of topics pertaining to their impending childbirth experience. I make it my job to empower them to
understand completely and have an appreciation of the facts, implications and
possible future consequences of their decision(s). <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">In order for a person to be ready for informed decision
making, they must first have the evidence-based information, be able to ask
questions freely in a non-judgmental and unbiased environment, be able to list
the pros and cons, discuss these findings not only with their support team but
also their health care provider, have</span></div>
<div class="separator" style="clear: both; text-align: center;">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><a href="https://2.bp.blogspot.com/-QjnOLgNyezU/WCDJDMLi69I/AAAAAAAADYU/9ySqdN0sOZgXy5gYEInuNj6PWwxO18yGwCLcB/s1600/informed%2Bconsent12.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://2.bp.blogspot.com/-QjnOLgNyezU/WCDJDMLi69I/AAAAAAAADYU/9ySqdN0sOZgXy5gYEInuNj6PWwxO18yGwCLcB/s1600/informed%2Bconsent12.JPG" /></a></span></div>
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"> time for their decision to be pondered,
and then implemented.<o:p></o:p></span><br />
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Based on the many acronyms for informed decision making from
BRAND (Benefits, Risks, Alternatives, Nothing, Decide) to BRAIN (Benefits,
Risks, Alternatives, Instinct, Now decide), clients can get their information
and study that information. Ideally, the
nurses and health care providers are responsible for obtaining the decision or
consent; the consent must be informed, voluntary and not obtained through
misrepresentation. Along with the ability to make this informed decision is
also the right to the information necessary to refuse care – the implications
of the right to refuse must also be clearly understood by the client. According to the Health Care Consent Act of
1996 (Ontario, Canada), “medical care is wrongful and “battery” unless the
patient has given consent to it.”<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Consent must also be free from bias in that health care
professionals should be insightful as to the power of their persuasiveness in
either word, voice inflection, facial expression or presentation. As mentioned in the ACOG Committee Opinion
439 (original date August 2009, reaffirmed 2015), “care should be taken that
the physician’s perspectives do not unduly influence a patient’s voluntary
decision making”. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Good communication is key to the success of informed
decision making. Collaborative
relationships between expectant clients, nurses, physicians, midwives,
childbirth educators, doulas and lactation consultants are unique and
specifically designed for a central focus – optimum birth outcomes. Ongoing communication
must be clear, distinct and respectful, focusing on the patient-centered care
and impact on the mother/baby dyad. To ensure
that these collaborative relationships are powerful and serve the expectant
client, the Institute of Medicine defines quality of care that improves
outcomes with Six Aims:<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">1. Safe – avoiding injuries to patients from the care that
is intended to help them.<br />
2. Effective – providing services based on scientific knowledge to all who
could benefit and refraining from providing services to those not likely to
benefit (avoiding underuse and over use).<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">3. Patient- centered – providing care that is respectful of
and responsive to individual patient preferences, needs and values and ensuring
that patient values guide all clinical decisions.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">4. Timely – reducing waits and sometimes harmful delays for
both those who receive and those who give care.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">5. Efficient – avoiding waste, in particular waste of
equipment, supplies, ideas and energy.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">6. Equitable – providing care that does not vary in quality
because of personal characteristics such as gender, ethnicity, geographic
location and socio-economic status.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">For childbirth educators and doulas, nurses, lactation
consultants, and midwives, our knowledge of the aspects of quality of care is
imperative to drive the informed decision making. Especially with doulas and childbirth
educators who are often the “first responders” with whom expectant parents
interact, we must stay focused on the latest information, what is and is not
evidence based, and be able to respond to our clients’ needs for informational resources. We cannot sit on our laurels and expect
someone else to take up the mantel and provide our clients with
information. If our clients hear
information multiple times from multiple sources, then so be it! They will know that those sources are quality
sources that can be trusted.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Study after study has proven that respectful care, and
respect for decision making can improve birth outcomes and satisfaction. And we as birth professional must continue to
ask the hard questions about the iatrogenic rise in interventions, including
cesarean section as compared to the rise of maternal/infant
morbidity/mortality. We must take care that
there is not disconnect in the communication and care continuum.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>For further review:</b><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 10.0pt;">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>ACOG Committee
Opinion 439</b><br />
<a href="http://www.acog.org/-/media/Committee-Opinions/Committee-on-Ethics/co439.pdf?dmc=1&ts=20150309T0843479479">http://www.acog.org/-/media/Committee-Opinions/Committee-on-Ethics/co439.pdf?dmc=1&ts=20150309T0843479479</a><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 10.0pt;">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>AWHONN: Women’s
Health and Perinatal Nursing Care Quality Draft Measures Specifications</b><br />
<a href="https://c.ymcdn.com/sites/www.awhonn.org/resource/resmgr/Downloadables/perinatalqualitymeasures.pdf">https://c.ymcdn.com/sites/www.awhonn.org/resource/resmgr/Downloadables/perinatalqualitymeasures.pdf</a></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 10.0pt;">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>Health Care Consent Act 1996</b> <a href="https://www.ontario.ca/laws/statute/96h02">https://www.ontario.ca/laws/statute/96h02 </a></span></div>
<br />
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 10.0pt;">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>IOM Six Aims:
Crossing the Quality Chasm</b><br />
<a href="https://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf">https://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf</a></span>
<o:p></o:p></div>
Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-58092689454740257852016-11-01T07:13:00.000-07:002016-11-07T10:47:25.062-08:00The Importance of ACOG's New Hydrotherapy Opinion: November 2016<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="font-family: "arial" , sans-serif; font-size: 10pt;">Available now in pre-release
online, ACOG's update on their April 2014 Opinion on Hydrotherapy contains some
interesting and impactful aspects. Here is a synopsis of the November
2016 Opinion Update.</span><span style="font-size: 13.5pt;"><o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="font-family: "arial" , sans-serif; font-size: 10pt;"><br />
ACOG states that hydrotherapy/water immersion is advisable for uncomplicated
pregnancies, and labors that occur after 37 0/7 and 41 6/7 weeks. They
suggest that labors may be shorter when hydrotherapy is in use, and the
incidence of epidural anesthesia is reduced. This implies, as both evidence-based
information and anecdotal information shows, that hydrotherapy reduces the
perception of pain during labor.</span><span style="font-size: 13.5pt;"><o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="font-family: "arial" , sans-serif; font-size: 10pt;"><br />
While the opinion says that sufficient evidence does not exist to fully inform
laboring women of the risks and benefits of hydrotherapy, the opinion states
that the laboring woman should not only be advised of risks and benefits but
also the hospital must establish strict protocols surrounding hydrotherapy.
Until sufficient data does exist, the opinion is that birth should be on
"land" rather than in "water". </span><span style="font-size: 13.5pt;"><o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="font-family: "arial" , sans-serif; font-size: 10pt;"><br />
<span style="background: white;">Most importantly, the opinion states that
"a woman may request immersion during the second stage of labor, including
giving birth while submerged. This decision should represent an informed
choice; a woman who requests to give birth while submerged in water should be
informed that the maternal and perinatal benefits and risks of this choice have
not been studied sufficiently to either support or discourage her
request."</span></span><span style="font-size: 13.5pt;"><o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="background: white; font-family: "arial" , sans-serif; font-size: 10pt;"><br />
Interestingly, the references used range from the early 1990s to 2016. In
fact 21 of the 39 references would be considered unusable by the "within
3-5 year" rule of references used by many hospitals, physicians, nurses,
childbirth educators and other birth professionals. The opinion, however,
does use the ACNM Position Statement on Hydrotherapy, the Royal College of
Midwives Guidelines on Hydrotherapy and the NICE Guidelines on Intrapartum Care
(includes hydrotherapy) as references.<o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<br /></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="background: white; font-family: "arial" , sans-serif; font-size: 10pt;">Among the missing
from the opinion is information from earlier in 2016 from the largest cohort
study, with nearly 18,000 in the U.S. study.
The study from the <i><a href="http://onlinelibrary.wiley.com/doi/10.1111/jmwh.12394/pdf">Journal ofMidwifery and Women’s Health</a></i> (full text available from this link) reported separately on outcomes for
mother-baby dyads. The research used in
the study was from the Midwives Alliance of North America Stats Project with
births during the years 2004-2009. Since the information did come from the MANA
Project, the women in the project gave birth either at home or at a birth
center – this may or may not make them representative of all U.S. childbearing
women, as they received minimal medical intervention. The key piece to this voluminous study is
that water labor/water birth did not confer an increased risk of newborn
morbidity/mortality, suggesting that
waterbirth “is a reasonably safe option for use in low-risk, low
intervention births – especially when the risks associated with other forms of
pharmacologic pain management are considered.”</span><span style="font-size: 13.5pt;"><o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="background: white; font-family: "arial" , sans-serif; font-size: 10pt;"><br />
To accurately discern your own opinion about water labor and water birth based on
the evidence available world wide, I highly suggest the following resources:<o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<br /></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="background: white; font-family: "arial" , sans-serif; font-size: 10pt;"><a href="http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Immersion-in-Water-During-Labor-and-Delivery">ACOG CommitteeOpinion #679 November 2016 Immersion in Water During Labor and Delivery</a><o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<br /></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<a href="http://www.midwife.org/acnm/files/ccLibraryFiles/Filename/000000004048/Hydrotherapy-During-Labor-and-Birth-April-2014.pdf"><span style="background: white; font-family: "arial" , "sans-serif"; font-size: 10.0pt;">ACNM
Position Statement on Hydrotherapy</span></a><span style="background: white; font-family: "arial" , sans-serif; font-size: 10pt;"> <o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<br /></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<a href="http://www.activebirthpools.com/wp-content/uploads/2014/05/RCOG-waterbirth.pdf"><span style="background: white; font-family: "arial" , "sans-serif"; font-size: 10.0pt;">Royal
College of Obstetrics and Gynecologists/Midwives joint statement</span></a><span style="background: white; font-family: "arial" , sans-serif; font-size: 10pt;">.</span><span style="font-size: 13.5pt;"><o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="background: white; font-family: "arial" , sans-serif; font-size: 10pt;"><br /></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="background: white; font-family: "arial" , sans-serif; font-size: 10pt;"><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4210671/">"Birth Bath and Beyond: The Science and Safety of Water Immersion during Labor and Birth"</a> by Barbara Harper in the <i>Journal of Perinatal Education </i>(2014)</span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="background: white; font-family: "arial" , sans-serif; font-size: 10pt;"><br /><a href="http://evidencebasedbirth.com/waterbirth/">Evidence Based Birth</a> - this article is a history of waterbirth and a perspective on the previous ACOG Opinion of 2014.</span></div>
<br />
<div class="MsoNormal">
<br /></div>
Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-30382007899007888422016-09-27T05:39:00.000-07:002016-09-27T05:39:03.678-07:00The World Council on Birth<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">The World Council on Birth is one of the most prestigious organizations we've ever seen. Shortly after it's inception, representatives from all of the leading maternity nursing, childbirth education, doula, lactation, midwifery and physician organizations flocked to the first annual meeting!</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">During that amazing first annual meeting, which lasted seven days, members of the Council discussed the alarming rise in cesarean section rates, maternal morbidity/mortality rates, and infant morbidity/mortality rates. </span><br />
<div class="separator" style="clear: both; text-align: center;">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><a href="https://1.bp.blogspot.com/-3Je40QK-m8g/V-pmJVpvCnI/AAAAAAAADXk/OlZREJZdsCg8ZOWC3CAZYZAoxcDJh1IxgCLcB/s1600/World%2Bcouncil%2Bof%2Bbirth.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://1.bp.blogspot.com/-3Je40QK-m8g/V-pmJVpvCnI/AAAAAAAADXk/OlZREJZdsCg8ZOWC3CAZYZAoxcDJh1IxgCLcB/s200/World%2Bcouncil%2Bof%2Bbirth.JPG" width="198" /></a></span></div>
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Evidence based information on every conceivable topic was presented on both a flash drive and print version to each Council member. It was also posted on the WCB website. During committee discussions, great headway was made on how to implement evidence-based information in medical school/nursing school teachings, hospitals and birth centers.</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">The high point of the annual meeting came when one Council member demanded that the observation that everything that is done during the birth process directly impacts breastfeeding implementation, success and duration. The entire Council rose to its feet with a 25 minute standing ovation. Then it was back to work in committees to implement yet another stellar concept.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Since that first annual meeting, 55% of the world's </span><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">medical school/nursing school, hospitals and birth centers are actively implementing the evidence-based policies and procedures, with another 22% coming by the end of the year. Implementation includes drastic changes in practices, training of all staff in evidence-based/physiologic birth practices and mother-friendly/baby-friendly care. Over 400 hospitals in the US alone have begun hospital-based doula programs and another 600 are actively referring to doulas in the community. The statistics for attendance at childbirth education classes is staggering also - we have seen a jump from 34% attendance to 77% attendance in just a few short months in the US.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">We are just beginning to see the fruits of their labors! C</span><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">esarean section rates, maternal morbidity/mortality rates, and infant morbidity/mortality rates are beginning a slow but steady decline in every country. Postpartum PTSD and PMAD and just now also beginning to decline somewhat. We are making progress! We ARE moving forward.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;"><b><i><u>(Disclaimer: the above information about the World Council on Birth is 100% satire. Absolutely none of it is true or accurate. It is all made up. It is an exaggeration. And how disappointing!)</u></i></b></span>Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-65138057887909431552016-09-19T07:09:00.001-07:002016-09-19T07:21:36.685-07:00What the Lancet has to say about TLTL and TMTS<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Acronyms have become a part of our culture, especially with texting. LOL, ICYMI, and others are part of our new vernacular. However, two new acronyms were introduced on September 15, 2016 by the <i>Lancet</i>: TLTL and TMTS. Here's what authors Miller et al had to say:</span><br />
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<a href="https://2.bp.blogspot.com/-X-vXLEUXKjs/V9_xeoh51oI/AAAAAAAADXM/Od95ODu_bNgFdDbTv5eY20Jb-mKlTRKUACLcB/s1600/alarm.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="130" src="https://2.bp.blogspot.com/-X-vXLEUXKjs/V9_xeoh51oI/AAAAAAAADXM/Od95ODu_bNgFdDbTv5eY20Jb-mKlTRKUACLcB/s200/alarm.JPG" width="200" /></a><span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">In a recent article titled "Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide", authors Miller et al have identified that we are at an intersection in maternity care: too little, too late (TLTL) and too much, too soon (TMTS). They describe </span><span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">TLTL care with inadequate resources, below evidence-based standards, or care withheld or
unavailable until too late to help. TLTL is an underlying problem associated with high maternal mortality and
morbidity in many countries, not just the United States. Also described is the concept of TMTS: the routine over-medicalization of normal pregnancy and birth. TMTS includes
unnecessary use of non-evidence-based interventions, as well as use of interventions that can be life saving when
used appropriately, but harmful when applied routinely or overused. It has been found that TMTS causes human harm and increases health costs, and many times, concentrates disrespect and abuse. </span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Moving from "just" a maternity issue to a global public health issue, TLTL and TMTS has at the core a lack of evidence-based maternity care (EBMC). EBMC includes care that is humane and dignified, and delivered with respect for a woman's fundamental rights. In the <i>Lancet's Midwifery Series</i>, it has been shown that women not only value appropriate clinical interventions but also timely information and support so they can make the best possible informed decisions. Patient satisfaction with care rises when this information and support leads to a feeling of dignity and control. Yet, evidence continues to demonstrate that women are too frequently not informed of risks nor have they been given informed consent for medical interventions. Leading international childbirth education and maternal/child health organizations have been say this for decades.</span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">A prime example is the 2010 estimation that there were 3.5-5.7 million unnecessary cesareans done. Cesarean section is an aspect of maternity care that is globally monitored and an example of an intervention that can be either TLTL or TMTS with disparity rates in nearly every country on earth. While cesarean rates appear to be somewhat decreasing in the US, they are rising globally.</span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Significant to this conversation is the failure of the medical community to embrace and put into the practice evidence-based care. Known as the "Know-do" gap, research shows that there is a sluggish effort for implementation of evidence-based care. A dynamic effort must be made to target providers of maternity care for dissemination of this information, while also doing an audit of action, feedback and additional targeted educational interventions. In short, the buy-in for reducing the "Know-do"gap and improving maternity care (plus improving maternal/infant morbidity/mortality rates) must be felt at all levels of management. </span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">The words "move toward more respectful maternity care" should basically scare the hell out of care providers today. The implication that today's care is not respectful to a woman's physical, mental and emotional health goes against what many of us joined the profession to provide. It can be shocking to know that traditional practices that are the "way we've always done it" are actually harmful for women. Denial and anger are common responses to this epiphany.</span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">As more and more research and statistics are revealed, the pressure on care providers will increase. For hospital policies, procedures and practice guidelines to change there must be also social and economic pressure for change. There needs to be intense pressure from the customer of maternity care for respectful care without fear of retribution. There should also be pressure from insurance companies to refuse reimbursement for non-evidence based care. Unfortunately, if we cannot appeal to the care providers' hearts, we will need to hit them in the wallet.</span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Providing evidence- based respectful care is not impossible. There are providers, facilities and whole health care systems that have embraced implementation and currently practice this type of health care. Sadly, the majority do not.</span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">The authors state that excessive, unnecessary or inappropriate use of obstetric interventions in health facilities are a cause for concern. I believe we've been concerned and complacent for too long. Too many women have been the victim (yes, I said victim) of this type of inadequate care. I say it is now time to sound the alarm.</span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Miller, S. et al. (2016) Beyond too little too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide. <i>The Lancet.</i> </span><span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Published online September 15, 2016 http://dx.doi.org/10.1016/S0140-6736(16)31472-6</span>Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-28669993423337094932016-09-12T08:10:00.005-07:002016-09-12T08:10:59.950-07:00Discussing the New WHO Standards for Improving Quality of Maternal and Newborn Care in Health Facilities - Trying to Address the Flaws in the System<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">In a welcome response to the stagnate reduction in maternal/infant morbidity/mortality as well as a response to the quality of care that contributes to maternal/infant morbidity/mortality, the World Health Organization has created the new global document, "Standards for Improving Quality of Maternal and Newborn Care in Health Facilities".</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">This document centers around eight standards that the WHO feels should be implemented, monitored and improved based on the health care system in which it is adopted. Not unlike the Healthy People 2010 and 2020 </span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><a href="https://4.bp.blogspot.com/-ndK9vOwPWiI/V9bFaKX38CI/AAAAAAAADW8/Hwg58tqixhorqOut3W7t5HaijGaAlx7zACLcB/s1600/WHO%2Bstandards.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://4.bp.blogspot.com/-ndK9vOwPWiI/V9bFaKX38CI/AAAAAAAADW8/Hwg58tqixhorqOut3W7t5HaijGaAlx7zACLcB/s1600/WHO%2Bstandards.JPG" /></a></span></div>
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">standards, the WHO standards define exactly what is needed to obtain high quality care during the childbirth experience. Each standard is followed by a series Quality Statements that further define what researchers are looking for in the standard. </span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">While the use of the word "routine" is seen several times, it is the desire of the WHO Standards writers that evidence-based care <i>become </i>routine and not be the exception. In far too many facilities world wide, evidence-based care is not practiced. Traditional practices, perhaps years old, are the rule and not to be questioned. This is a matter of culture and understanding. In more industrialized nations, the use of evidence-based care has been slow to be embraced in part due to the political bureaucracy of the hospital system. Creating, researching, reviewing, approving, and implementing new policies, procedures and practice guidelines takes time. Unfortunately, time is something that those in management positions rarely has and so the old adage, "if it ain't broke, don't fix it" becomes an unspoken mantra. Again, unfortunately, many policies, procedures and practice guidelines do need to be updated or even recreated to ensure evidence-based care. This is where there is a flaw in the system.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Below is a list of the Standards.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>Standard 1.</b> Every woman and newborn receives routine, evidence-based care and management of complications during labour, childbirth and the early postnatal period, according to WHO Guidelines. </span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>Standard 2.</b> The health information system enables use of data to ensure early and appropriate action to improve the care of every woman and newborn.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>Standard 3.</b> Every woman and newborn with condition(s) that cannot be dealt with effectively with the available resources is appropriately referred.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>Standard 4.</b> Communication with women and their families is effective and responds to their needs and preferences.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>Standard 5</b>. Women and newborns receive care with respect and preservation of their dignity.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>Standard 6</b>. Every woman and her family are provided with emotional support that is sensitive to their needs and strengthens the woman's capability.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>Standard 7.</b> For every woman and newborn, competent, motivated staff are consistently available to provide routine care and manage complications.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>Standard 8</b>. The health facility has an appropriate physical environment, with adequate water, sanitation and energy supplies, medicines, supplies and equipment for routine maternal and newborn care and management of complications.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">These standards, as do the Healthy People 2020 Initiative, help to develop a proper framework, set of definitions and standards of care. These standards have not been created by chance, but by a comprehensive set of research standards assessing the global issue of </span><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">maternal/infant morbidity/mortality. Resources for research of the standards included The Joint Commission (US), the National Institute for Health and Care Excellence (NICE) UK, the Council for Health Service Accreditation of Southern Africa, and the Australian Commission on Safety and Quality in Health Care (2012).</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Each standard carried the same characteristics of the care being safe, effective, timely, efficient, equitable and people-centered. This is of particular interest to childbirth educator and doulas who, as part of their role today, act as guardians of labor support and informed consent. For expectant families to truly understand if these eight standards are being implemented by their hospital or facility, education becomes the key. Standard 4 discusses at length the importance of effective communication - communication cannot be effective if both sides of the conversation are not speaking the same language. By same language, I don't imply English or French. I am talking about the knowledge of labor and birth, effective and evidence-based care, <i>and</i> listening to the mother's preference. When preferences cannot be granted due to medical complications, appropriate care and information must be given that is respectful and preserves dignity.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Standard 6 is nearly a mandate for birth doula care. What else can I say? The research for the last 30+ years screams the benefits of doula care for the expectant/laboring/postpartum mother! Why oh why are we so....very...slow...to embrace that which improves outcomes and patient satisfaction? What is the medical community afraid of? Yes, afraid? Is it financial? My feeling has always been that if a hospital had a doula program, they could market that in an incredible way and become the hero of the community based on maternal satisfaction alone. And we all know who drives the medical referral bus in families - yes, mothers. It is one of those magical moments that hospitals are missing.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: x-small;">To read more and get your </span><b><u>FREE</u></b><span style="font-size: x-small;"> copy of the WHO Standards of Care,</span><a href="http://apps.who.int/iris/bitstream/10665/249155/1/9789241511216-eng.pdf?ua=1" style="font-size: small;"> click here</a><span style="font-size: x-small;">.</span></span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><br /></span>Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-10269609344201372452016-09-07T12:26:00.002-07:002016-09-07T12:26:52.252-07:00Being Creative in Marketing Your Business – It’s a Jungle Out There!<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Marketing a small business is so different from marketing
just ten years ago! Technology has grown
by leaps and bounds and has changed the landscape of marketing dramatically.
Marketing in 2016 needs to include not only print media (business cards, print
advertising), but electronic media (Facebook, Twitter, Instagram). This can either cause creative juices to flow
OR completely stymie someone. Not all of
us are marketing experts….some </span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><a href="https://3.bp.blogspot.com/-A03PP810n8Q/V9BoQdWv2RI/AAAAAAAADWk/ad5ZFn3aIl03ganzk-HQXC_n_vtts9o4gCLcB/s1600/jungle.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="140" src="https://3.bp.blogspot.com/-A03PP810n8Q/V9BoQdWv2RI/AAAAAAAADWk/ad5ZFn3aIl03ganzk-HQXC_n_vtts9o4gCLcB/s200/jungle.JPG" width="200" /></a></span></div>
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">of us are truly challenged. There are some tips to help even the most
novice marketing person.<o:p></o:p></span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>Tip #1</b> – realize your
true value to your prospective clients.
Be honest and write it down. This
will give you content to use when you are in creative mode.<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>Tip #2</b> – plan your
marketing budget. This should be a
percentage of your annual income and will be used over the course of the
year. Be sure to save some in case you
find something absolutely amazing late in the year!<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>Tip #3</b> – create
your style. Select a font that you will
use almost exclusively, a logo, a company tag line, and even colors. This will make you recognizable immediately,
no matter what the message that you are promoting!<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><br /></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>Tip #4</b> – identify
your target market. Know who will be
using your products or services. Then
study how they learn and to what they respond.
What is the age group and what medium do they use for learning? Once you have answers to these questions,
this will provide you with a basic pathway of how to spend your marketing
dollars.<o:p></o:p></span></div>
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<br />
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<a href="https://2.bp.blogspot.com/-QWb7M39LuBM/V9BoYR2XwjI/AAAAAAAADWo/nfiQoC1zKvkiu2NE8eew6OgXq9nFkl5RwCLcB/s1600/creating%2Band%2Bmarketing.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://2.bp.blogspot.com/-QWb7M39LuBM/V9BoYR2XwjI/AAAAAAAADWo/nfiQoC1zKvkiu2NE8eew6OgXq9nFkl5RwCLcB/s200/creating%2Band%2Bmarketing.JPG" width="128" /></a></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><b>Tip #5</b> – Do you
need more specific details about marketing?
Wish there was a workbook that you could use to walk you through the
entire process? Consider <a href="http://www.birthsource.com/scripts/prodView.asp?idproduct=411"><i>Creating and Marketing Your Birth RelatedBusiness</i> </a>! This book was written by a childbirth professional (me!) and a marketing expert Heather Livingston BA, BBA, MBA (my daughter!). The first edition has helped nearly 7,000 birth professionals make marketing efforts more meaningful and beneficial for the business. This new second edition has even more tips and tricks that are proven to bring more clients and more business. With easy to use concepts and worksheets after each chapter, this may be a wise edition to your business library!</span><o:p></o:p></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Order yours today! Or visit our exhibit booth at the ICEA Annual Conference to get a signed copy!</span></div>
<strong class="CO" style="color: #ff0066; font-family: Verdana, Arial, Helvetica; font-size: 8pt; line-height: 24px;"><form action="http://www.birthsource.com/scripts/cart.asp" method="post" name="additem">
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</strong>Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-83747503584797385732016-08-29T13:54:00.000-07:002016-08-29T13:54:08.769-07:00The Top 12 Evidence-Based Resources for Birth Professionals<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">With social media feeding information to our clients like a
fire hose, it can be overwhelming for birth professionals (childbirth
educators, doulas, lactation consultants) to discern all of the information and
change curriculum or visit information to address every issue.<o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">So with all of the information available to us, how do we
choose which ones to heed and which ones to ignore? <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-family: Verdana, sans-serif; font-size: x-small;">Top Websites for
Evidence-Based Information (in no particular order, except for #1)<o:p></o:p></span></b></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><a href="http://www.birthbythenumbers.org/">www.birthbythenumbers.org</a>
This website was conceived by Dr. Gene Declercq and has been developed by a
group of students from Boston University School of Public Health. If you don’t know about Dr. Declercq, that
should be the very first thing you Google.
He is incredibly intelligent and has been a prolific writer and
disseminator of truth for several decades.
I am his </span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><a href="https://1.bp.blogspot.com/-zu0o5-cFkn0/V8Sgzwp9kmI/AAAAAAAADWQ/GpO2r1g9CUogMy6ItpMQzdUSDWp9p5HTgCLcB/s1600/always%2Bseek%2Bknowledge.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="207" src="https://1.bp.blogspot.com/-zu0o5-cFkn0/V8Sgzwp9kmI/AAAAAAAADWQ/GpO2r1g9CUogMy6ItpMQzdUSDWp9p5HTgCLcB/s320/always%2Bseek%2Bknowledge.JPG" width="320" /></a></span></div>
<span style="font-family: Verdana, sans-serif; font-size: x-small;">greatest fan.<o:p></o:p></span><br />
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"> <a href="http://www.childbirthconnection.org/">www.childbirthconnection.org</a> Once known as the Maternity Center
Association (show me a childbirth educator with over 25 years of experience and
I’ll show you her Birth Atlas from MCA!) since 1918, this program is now a core
of the National Partnership for Women and Families.<o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><a href="http://www.marchofdimes.org/">www.marchofdimes.org</a>
The March of Dimes and in particular their “Healthy Babies are Worth the Wait”
focuses on reducing elective births before 39 weeks.<o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"> <a href="http://www.kellymom.com/">www.kellymom.com</a> It’s all about
breastfeeding – great info for both professionals and parents!<o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><a href="http://www.midirs.org/">www.midirs.org</a> The
Midwives Information and Resource Service is a not-for-profit educational
charity providing essential materials to assist midwives and other
professionals.<o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><a href="http://www.vbac.com/">www.vbac.com</a> Fantastic website for info on cesareans and VBACs.</span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;">and of course.......</span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><a href="http://www.birthsource.com/">www.birthsource.com</a> Celebrating 17 years of evidence based information for both parents and professionals.</span></div>
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<b><span style="font-family: Verdana, sans-serif; font-size: x-small;">Top Books as
Reference for Birth/Breastfeeding Professionals (in no particular order)<o:p></o:p></span></b></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><i>Natural Hospital Birth: The Best of Both Worlds</i> (2011) by
Cynthia Gabriel.<o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><i>Optimal Care in Childbirth: The Case for a Physiologic
Approach </i>(2012) Amy Romano and Henci Goer.<o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><i>The Birth Partner 4<sup>th</sup> Edition: A Complete Guide
to Childbirth for Dads, Doulas and All Other Labor Companions. </i>(2013) by Penny
Simkin.<o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><i>Pregnancy Childbirth and the Newborn The Complete Guide</i>
(2016) by Penny Simkin and Janet Whalley.<o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><i>Impact of Birthing Practices on Breastfeeding </i>(2010) by
Linda J. Smith.<o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><i>Sweet Sleep: Nighttime and Naptime Strategies for the
Breastfeeding Family</i> (2014) by Diane </span><span style="font-family: Verdana, sans-serif; font-size: x-small;">Wiessinger, Diana West, Linda Smith and
Teresa Pitman.<o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;"><i>The Nursing Mother’s Companion 7<sup>th</sup> Edition.</i>
(2015) by Kathleen Huggins.<o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;">Is there a book you feel should be on this list? Email me at <a href="mailto:info@birthsource.com">info@birthsource.com</a> and I’ll be happy
to share it with my readers!<o:p></o:p></span></div>
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Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-47469416142152884892016-08-22T15:45:00.002-07:002016-08-22T15:45:53.004-07:00Why Childbirth Education IS Still Important!<div class="separator" style="clear: both; text-align: center;">
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<span style="font-family: Verdana, sans-serif; font-size: x-small;">Researchers agree that antenatal education (aka childbirth education) is a vital part of reducing maternal/infant morbidity and mortality rates, the rising cesarean rates and the growing fear of childbirth. </span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;">On September 19, I have the privilege of joining five other experts in childbirth education to share with you not only why we believe that childbirth education is still important but what the evidence says. Thanks to Injoy Birth and Parenting of Boulder Colorado, "Why Childbirth Education is Still Important" is the newest in their free webinar series.</span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;">You'll hear from Penny Simkin, Cathy Allen, Vonda Gates, Colleen Weeks, Robin Weiss and myself as we explore how to encourage expectant parents to attend classes and teaching to the adult learner, why childbirth education is for every expectant parent and how to challenge the price of ignorance, getting the physicians on board with childbirth education classes, as well as the tokophobia (fear of childbirth) and the Birth/Breastfeeding relationship. And there will be time at the end of the webinar for you to ask questions!</span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;">Want to learn more about this free webinar from Injoy? <a href="http://injoyvideos.com/why-childbirth-education-is-still-important"> Click here!</a></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: x-small;">This amazing webinar is free but you do have to register. To register, <a href="https://attendee.gotowebinar.com/register/2025902227771905793">click here.</a></span></div>
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<a href="https://4.bp.blogspot.com/-fusM3H2RXmU/V7tFMNmpzpI/AAAAAAAADV0/_KRUl2qf9CMVC1BdVVJ4LruQHN-Hs3rXQCLcB/s1600/cbe%2Bis%2Bstill%2Bimportant%2Bfinal.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="301" src="https://4.bp.blogspot.com/-fusM3H2RXmU/V7tFMNmpzpI/AAAAAAAADV0/_KRUl2qf9CMVC1BdVVJ4LruQHN-Hs3rXQCLcB/s400/cbe%2Bis%2Bstill%2Bimportant%2Bfinal.JPG" width="400" /></a></div>
<br />Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-3803606573459398752016-08-08T09:58:00.000-07:002016-08-08T09:58:08.982-07:00Understanding an Op Ed Piece - "Get the Epidural"<div class="MsoNormal">
<span style="font-family: Trebuchet MS, sans-serif;">Last month (July 9 2016), Jessi Klein wrote an op-ed piece for the New York Times
titled “Get the Epidural” Here is the
link to the piece -<a href="http://www.nytimes.com/2016/07/10/opinion/sunday/get-the-epidural.html?_r=0"> <span style="color: #351c75;">click here.</span><o:p></o:p></a></span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">I do not normally respond to op-ed pieces because they are
just that, opinions. And I believe
everyone has the right to their opinion.
This is no exception.<o:p></o:p></span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">In her piece, Klein points out, either consciously or
subconsciously, several issues that expectant women grapple with nearly every
day.<o:p></o:p></span></div>
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<b><span style="font-family: Trebuchet MS, sans-serif;">Judgement<o:p></o:p></span></b></div>
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<span style="font-family: Trebuchet MS, sans-serif;">In life, we are unfortunately all subject to judgement and
criticism. Is it fair? No, especially not in the tender emotional
state of pregnant women. Strangers feel
it is accepted to ask personal questions and even invade personal space by
pointing at or even touching a pregnant belly.
These strangers feel that expectant women are warm and fuzzy mommies who
will be accepting of a variety of social behaviors. What strangers fail to recognize is that
expectant women are still people, with emotional and physical boundaries just
like anyone. And, these same expectant
women are fierce momma bears with an incredible protective instinct. So no wonder there can be a strong push-back
on invasions of personal space. <o:p></o:p></span></div>
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<b><span style="font-family: Trebuchet MS, sans-serif;">Symantics<o:p></o:p></span></b></div>
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<span style="font-family: Trebuchet MS, sans-serif;">The debate continues about the names of childbirth experiences. Words that have been tossed around include “natural”,
“normal”, “unmedicated”, “unassisted”, and “physiologic”. Most regular humans do not know the
difference and often use these interchangeably.
There may only be two types of childbirth: physiologic and intervented. Physiologic would mean that labor begins on
its own (without using any medications to begin or augment the labor progress),
void of interventions of any kind including medications (such as an epidural)
or instrumental assistance (forceps or vacuum).
Intervented would mean a labor and birth that required an intervention,
including the previously stated interventions or even a cesarean surgery. Both have their place in modern
obstetrics. <o:p></o:p></span></div>
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<b><span style="font-family: Trebuchet MS, sans-serif;">Birth options<o:p></o:p></span></b></div>
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<span style="font-family: Trebuchet MS, sans-serif;">Expectant women should thrive in an atmosphere of freedom to
make decisions about their birth experience based on the knowledge of
alternatives – such is part of the motto of the International Childbirth
Education Association. Klein implied she
was doing some learning and I hope that the internet is not her sole source of
information. I hope she explores books,
classes and perhaps even hires a doula who can significantly add to her
personal knowledge base. Expectant women who are in a solid place informationally
and who can make informed decisions, have incredible birth satisfaction and
some research has shown have a reduced incidence of postpartum mood disorders.</span></div>
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<b><span style="font-family: Trebuchet MS, sans-serif;">Tokophobia &
Relationship Issues<o:p></o:p></span></b></div>
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<span style="font-family: Trebuchet MS, sans-serif;">Klein’s last paragraph deals with her fear of different types
of pain, including pain associated with birth and breastfeeding. She seems unsettled about her postpartum
image and unsettled about adult relationships.
These are issue that may take time to resolve and are not uncommon! With so much information at our fingertips,
it is hard to discern what information is valid and what is tainted by
bias. Finding information that is
evidence-based can be more than expectant women can endure. This may be one reason why expectant women
find one source of information and remain locked on that source throughout
their pregnancy. True or biased, one
source is better and less time consuming than vetting multiple sources of
information. Doing intense investigation
can also facilitate the fear that may be present.<o:p></o:p></span></div>
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<b><span style="font-family: Trebuchet MS, sans-serif;">Support<o:p></o:p></span></b></div>
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<span style="font-family: Trebuchet MS, sans-serif;">Based on what I’ve said previously, I hope Klein cultivates
an environment of support. What support
looks like for expectant women is entirely up to them – whether that is family
support, social support, informational support, emotional support, or physical
support. All women need to feel
supported during the most challenging and exciting day of their life. To feel unsupported during this crucial time
brings about feelings of resentment and isolation. Feeling supported can promote calm and make
decision-making easier.<o:p></o:p></span></div>
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<span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div>
<span style="line-height: 115%;"><span style="font-family: Trebuchet MS, sans-serif;">Each woman has the opportunity to thoroughly
explore all options and information and based on that education, work together
with care providers to have the birth experience that they want. Even when some of the decisions are out of
their hands, women should cultivate a trusting relationship with their care
providers for just those times. </span></span>Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-78366074479052597242016-08-04T06:22:00.001-07:002016-08-04T06:22:31.059-07:00Finding Your Path in the World of Birth & Breastfeeding!<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><i><b>Disclaimer: As of this writing, I am currently the President of the International Childbirth Education Association www.icea.org.</b></i></span><br />
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><i><b><br /></b></i></span>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">The time has come for you to take the next step in your career. Perhaps you are still in high school or college. Or perhaps you are changing careers to something that fits your interest or passion? You may have helped friends and families with their birth experiences. Stories and research about pregnancy, birth and breastfeeding consume you. And perhaps, you think of yourself as a "birth junkie".</span><br />
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">Each week, I receive numerous email inquiries about how to begin a career in maternity care. Sometimes, it is a simple suggestion to change someone's major in college. More often, it is a question of changing career fields and the need for a referral to an organization through which certifications can be obtained.</span><br />
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">When investigating career options in the world of birth and breastfeeding, it is best to answer some preliminary questions:</span><br />
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span>
<br />
<ol>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Do I want to specialize in either birth or breastfeeding or both?</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Do I want to catch babies?</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">If I want to specialize in birth only, do I want to provide labor support or education or both? Do I want to be a nurse? Do I want to be a childbirth educator?</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Do I want to become a labor/birth doula?</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">What about prenatal yoga or prenatal exercise or pregnancy massage?</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">If specializing in breastfeeding only, do I want to teach or provide consultations or both?</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">What about the postpartum period? Do I want to become a postpartum doula or perhaps teach newborn care classes?</span></li>
</ol>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">Your next steps depend on the answers you have given to the questions above.</span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">If you would like to become a nurse and work in maternity or newborn care, this would take a college education and sitting for your state's nursing board exam. A membership organization for nurses who work in maternity care is AWHONN, the Association for Women's Health, Obstetric and Neonatal Nurses. Their website is <a href="http://www.awhonn.org/">www.awhonn.org</a>. </span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">If you are interested in catching babies, either becoming on obstetrician or midwife is the path you should take. Studying obstetrics and becoming a nurse midwife are both college degrees. A membership organization for nurse midwives is ACNM, the American College of Nurse Midwives. Their website is <a href="http://www.midwife.org/">www.midwife.org</a>. </span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">If you desire to become a non-nurse midwife, there are several schools in the United States that offer this path. You will want to explore your options at <a href="http://www.meacschools.org/">www.meacschools.org</a>. You will also want to investigate your state's legal stance on non-nurse midwifery. Should you wish to sit for the NARM exam and become a Certified Professional Midwife (CPM), please go to <a href="http://www.narm.org/">www.narm.org</a>. Other midwifery websites include MANA, the Midwives Alliance of North America (<a href="http://www.mana.org/">www.mana.org</a>) and the National Association of Certified Professional Midwives (<a href="http://www.nacpm.org/">www.nacpm.org</a>) </span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">Teaching childbirth education classes is an extremely rewarding career and one that is the most "schedule-able". This may be important to you if you are attending classes for a lateral degree or caring for your young children. While there are no standard requirements or state laws governing childbirth education, it is indeed important to choose an organization who (1) provides an up-to-date and evidence-based certification program; (2) collaborates with other organizations and entities to expand the scope of their programs and (3) has the support of a variety of leaders in the field of childbirth education and maternity care. An initial view of the organization's website will give you a snap shot of their organization. You may find their mission and vision statements, philosophy, white papers or Position Papers and training/certification requirements.</span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><b>For an overview of choosing a childbirth education organization, <a href="http://www.birthsource.com/scripts/article.asp?articleid=408">click here</a>.</b></span><br />
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><b><br /></b></span>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><b>For a quick, side-by-side comparison of childbirth education entities (with an international reach), please <a href="http://www.birthsource.com/pdffiles/Childbirtheducationcomparison.pdf">click here</a>.</b></span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">I use the word "entity" above because not all of the places from which you receive training for childbirth education (or even doula training) are organizations. Some of them are non-profit organizations and some of them are for-profit companies, where the owners profit. </span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">Some entities require membership for certification maintenance and some do not. Are there benefits to organizational membership? If you are a member of a professional organization, you may receive the following benefits:</span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div>
<ul>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">A unified voice for advocacy in the field.</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Representation in collaborative work with other professional organizations.</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Discounts on other trainings or certifications offered by the entity.</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Discounts on annual conferences offered by the entity.</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Applicable clinical updates such as newsletters, journals, etc.</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Updated information for recertification.</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Awards and scholarships.</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Specialized members-only areas of the website.</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Multiple levels of professional safeguards to minimize liability or risk.</span></li>
</ul>
</div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">Finding your place in the world of birth and breastfeeding can be difficult at first and often take twists and turns that you may not initially anticipate. Enjoy your time in this amazing career path!</span></div>
<div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<br />
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span>Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-8517679699578427182016-07-22T07:45:00.001-07:002016-07-22T07:45:37.189-07:00Heat Index Over 100 F: Tips on feeling good!<br />
<span style="font-family: Verdana, sans-serif; font-size: x-small;">This weekend may be the hottest weekend of the year with heat indexes well over 100F in many areas of the US! Our pregnant and breastfeeding clients need to know how to cope during these blistering hot days. </span><br />
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: x-small;">Here are some tips to help them feel good on hot days!</span><br />
<a href="https://1.bp.blogspot.com/-6oflc0eYCb4/V5Iu8u6UiGI/AAAAAAAADVc/pSh-7byty7USI5thgGfCe3NTDZjckmYVQCLcB/s1600/sunshine%2Bclip.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="181" src="https://1.bp.blogspot.com/-6oflc0eYCb4/V5Iu8u6UiGI/AAAAAAAADVc/pSh-7byty7USI5thgGfCe3NTDZjckmYVQCLcB/s200/sunshine%2Bclip.JPG" width="200" /></a><span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span><br />
<br />
<ol>
<li><span style="font-family: Verdana, sans-serif; font-size: x-small;">Stay well hydrated! Actually count the number of 8 ounce cups in a drink bottle. It may be surprising how much (or how little) is included! On a "normal" day, expectant and breastfeeding mothers need</span><u style="font-family: Verdana, sans-serif; font-size: small;"><i> at least </i></u><span style="font-family: Verdana, sans-serif; font-size: x-small;">64 fl oz or 8 - 8oz cups of water. During the summer months and during exercise, expectant and breastfeeding mothers may need as much as 128 fl oz or a gallon of water per day! Yes, all of that fluid may make urination a frequent item but it is so much better than the alternative!<br /></span></li>
<li><span style="font-family: Verdana, sans-serif; font-size: x-small;">Avoid diuretics such as caffienated beverages. Yes, that iced coconut caramel mocha looks amazing but a pregnant or breastfeeding mother will need to drink twice that in water to replace what is being excreted from the body.<br /></span></li>
<li><span style="font-family: Verdana, sans-serif; font-size: x-small;">Stay indoors. Especially during the hottest portions of the day which are typically 10 am to 4 pm.<br /></span></li>
<li><span style="font-family: Verdana, sans-serif; font-size: x-small;">When outdoors, wear a large brim hat and use sunscreen, preferably a broad spectrum sunscreen - UVA/UVB.</span></li>
</ol>
<br />
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><b><u>Know the signs of Heat Exhaustion!</u></b></span><br />
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: x-small;">There are two types of heat exhaustion, water depletion (signs include thirst, weakness, headache, loss of consciousness) and salt depletion (signs include nausea and vomiting, muscle cramps and dizziness). Urine may also have a dark color and the heart may beat rapidly. While less than heat stroke, heat exhaustion may require medical attention. Certainly getting out of the heat and into air conditioning, resting, hydrating, and other cooling measures such as cool shower, fans or cold towels. For more about heat exhaustion, see <a href="http://www.webmd.com/fitness-exercise/heat-exhaustion">Web MD</a>.</span><br />
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><u><b>Know the signs of Heat Stroke!</b></u></span><br />
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: x-small;">According to <a href="http://www.webmd.com/a-to-z-guides/heat-stroke-symptoms-and-treatment#1">Web MD,</a> the symptoms of heat stroke include core body temp of 105F, dizziness or fainting, seizures, confusion, and disorientation. It is imperative to call 911 or seek medical attention immediately while trying to cool the body!</span><br />
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: x-small;">The best advice is to stay in where it is cool and hydrate! The hot weather will pass and soon cooler weather will be on its way!</span>Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-48208648199322567712016-07-18T11:56:00.000-07:002016-07-18T11:56:25.317-07:00Celebrating World Breastfeeding Week August 1-7<div class="separator" style="clear: both; text-align: center;">
<a href="https://1.bp.blogspot.com/-2LwIvQuP1fs/V40lcKf_AhI/AAAAAAAADVM/Stp-QOalqwMQq6gIHjFDPKV0hpxPIXj2wCLcB/s1600/2016%2BWorld%2BBreastfeeding%2BWeek.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="123" src="https://1.bp.blogspot.com/-2LwIvQuP1fs/V40lcKf_AhI/AAAAAAAADVM/Stp-QOalqwMQq6gIHjFDPKV0hpxPIXj2wCLcB/s320/2016%2BWorld%2BBreastfeeding%2BWeek.JPG" width="320" /></a></div>
<br />
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">August 1-7 is traditionally celebrated as World
Breastfeeding Week! World Breastfeeding
week is an annual celebration in more than 120 countries, with 540 events
world-wide and nearly 410,000 participants.
Organized by WABA, WHO and UNICEF in 1992, WBW promotes the value of
breastfeeding for mothers as well as children.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">Start planning now as to how you’ll bring this forward into
your community.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">The objectives of this year’s celebration are<br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">1) To inform
people about the new Sustainable Development Goals (SDG) and how they relate to
breastfeeding and Infant and Young Child Feeding;<br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">(2) To firmly anchor
breastfeeding as a key component of sustainable development;<br /> </span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">(3) To galvanise a
variety of actions at all levels on breastfeeding and IYCF in the new era of
the SDGs;<br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">(4) To engage and collaborate with a wider range of actors around
promotion, protection and support of breastfeeding.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">Available on the website are downloads of the WBW logo with
subtitles in many languages, Action Folders in many languages, as well as WBW 2016 Posters in many
languages.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
</div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">Find logos, Action Folders and Posters here: <a href="http://worldbreastfeedingweek.org/downloads.shtml">http://worldbreastfeedingweek.org/downloads.shtml</a></span>
<o:p></o:p></div>
Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-37009494978177077822016-07-14T12:34:00.000-07:002016-07-14T12:34:08.896-07:00That Moment When A Doctor Says He Won’t Refer To Your Childbirth Classes<div class="MsoNormal">
<b><i><span style="font-family: Verdana, sans-serif; font-size: x-small;">Scenario:<o:p></o:p></span></i></b></div>
<div class="MsoNormal">
<b><i><span style="font-family: Verdana, sans-serif; font-size: x-small;">A childbirth educator receives a
phone call from a local physician. He
proceeds to tell her that he no longer will be referring his patients to her
childbirth classes (or doula service).
His reasoning is that her clients ask too many questions. They know the risks and benefits of multiple
procedures (such as induction) and often refuse certain procedures (not
inappropriate refusals). This is
bothersome to him and keeps him from practicing medicine the way he desires.<o:p></o:p></span></i></b></div>
<div class="MsoNormal">
<b><i><span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></i></b></div>
<div class="MsoNormal">
<a href="https://4.bp.blogspot.com/-qzq0Cq77l6c/V4fpBf9RakI/AAAAAAAADU8/g5nXHYmp24Iw2PdBTs6xDJvK5p55IoC3wCLcB/s1600/Surprise%2Bface.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://4.bp.blogspot.com/-qzq0Cq77l6c/V4fpBf9RakI/AAAAAAAADU8/g5nXHYmp24Iw2PdBTs6xDJvK5p55IoC3wCLcB/s1600/Surprise%2Bface.JPG" /></a><span style="font-family: Verdana, sans-serif; font-size: x-small;">Some who read this blog post will
say that I am making up the scenario.
Well, unfortunately, I am not.
This event really happened in 2016.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">At first glance, this scenario
might truly make this childbirth educator/doula question her practice. She may feel that she is doing something
wrong. She may feel guilty.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">But why?<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">Clearly, the physician in this
scenario played all of his cards in one turn.
What did he really say?<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">He said:<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">He will no longer refer any of
his obstetric patients for childbirth educator or doula care.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">It makes the physician
uncomfortable that patients who attend this educator’s classes or become her
doula clients are exceptionally educated either before or during their time
with her. Yes, patients can learn on
their own via books, friends, family, or the internet. The patients also have a brain that can
reason. If a procedure sounds as if it
could interfere with natural hormonal orchestration of childbirth, which can
also stimulate hormones essential to bonding and mothering.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">Because of this knowledge of
evidence-based information, this physician feels threatened and anger.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">When they question or
appropriately refuse (such as in the case of induction for convenience rather
than clinical reason), again, the physician feels threatened and angry.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">The fact that patients have
evidence-based information and ask questions indicates that the physician is
expected to practice according to the evidence.
This may be contrary to the way he has been practicing: the way he was
taught or the way he wants to practice, as the latter meets his personal
needs. <i>His needs</i>.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">Since the physician is concerned
about his own needs being met, the needs of his patients are of no concern to
him as long as the outcome of the birth experience is not medical tragic. What the woman wants and what may actually be
best for a truly positive birth outcome is of no interest to this physician.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">What is the takeaway from this
for the childbirth educator?<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
</div>
<ul>
<li><span style="font-family: Verdana, sans-serif; font-size: x-small;">The quality of education that
this person provides is evidence-based, and empowers her clients.</span></li>
<li><span style="font-family: Verdana, sans-serif; font-size: x-small;">Her clients are empowered to own
the information.</span></li>
<li><span style="font-family: Verdana, sans-serif; font-size: x-small;">Her clients are acting like
consumers and are asking for practices changes that are in alignment with the
evidence.</span><span style="font-family: Verdana, sans-serif; font-size: x-small;"> </span></li>
<li><span style="font-family: Verdana, sans-serif; font-size: x-small;">Even though the physician does
not refer to her, there are numerous other ways to market the childbirth education
classes or doula services.</span><span style="font-family: Verdana, sans-serif; font-size: x-small;"> </span></li>
<li><span style="font-family: Verdana, sans-serif; font-size: x-small;">Clients who want to attend these
classes or have these services have the right to change care provider.</span></li>
<li><span style="font-family: Verdana, sans-serif; font-size: x-small;">It is their birth.</span></li>
<li><span style="font-family: Verdana, sans-serif; font-size: x-small;">It is their birth.</span></li>
<li><span style="font-family: Verdana, sans-serif; font-size: x-small;">It is their birth.</span></li>
</ul>
<br />
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">This educator/doula should not
give up. She is obviously doing her job
very effectively. Initially there might
be some hurt, but after careful consideration, she will find that it is all
about the physician and not her.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
</div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">Additionally, this is one reason
why we must, as childbirth educators and doulas, have in our skill set arsenal
a strong understanding of marketing and social media. We may not be able to depend on others to
refer clients to us. We have to let
expectant parents know that we are out there!
We must let them know that there is information to be learned,
techniques to be mastered and options to be exercised.</span><o:p></o:p></div>
<div class="MsoNormal">
<o:p></o:p></div>
Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-26176453240470923952016-06-21T06:17:00.001-07:002016-06-21T06:18:19.465-07:005 Tips for Keeping Social Media in Perspective as a Tool for Evidence-based Maternity Care<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">F</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;">or many years, I have been an advocate of social media in
maternity care. I felt from the
inception of the internet, that websites would be a one of the newest ways that
expectant parents could learn about evidence-based birth. With the advent of social media such as
Facebook, I once again heralded this as an adjunct to childbirth education. I am happy to report that many expectant
parents use web-based learning!<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<a href="https://2.bp.blogspot.com/-N7yZn9VXbpQ/V2k-Nv_dtlI/AAAAAAAADUk/OpMXCuOuDO4rNWrKo_UBx9uAqer5P2JUACLcB/s1600/me%2Bnot%2Bcaring.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="141" src="https://2.bp.blogspot.com/-N7yZn9VXbpQ/V2k-Nv_dtlI/AAAAAAAADUk/OpMXCuOuDO4rNWrKo_UBx9uAqer5P2JUACLcB/s200/me%2Bnot%2Bcaring.JPG" width="200" /></a><span style="font-family: "verdana" , sans-serif; font-size: x-small;">However, in the recent months, social media has become laden
with current events so disturbing and so evil.
Many of my colleagues are reporting mass unfollowing of individuals who
are send too toxic messages through social media. Even news outlets with social media accounts
have become toxic just by reporting the current events. Social media has become a platform for not
only political stances but racial and other volatile issues. And the atmosphere is not just “sharing”. The atmosphere can be down-right angry.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">According to the Huffington Post, 28% of people say social
media influences their music choices, television viewing and products
purchased. A whopping 57% of social
media users say their lives are stressful (due in part to social media). This stress may be due to projecting a
certain image of their life, stating their opinion on an issue, defending their
opinion on an issue or being apprehensive about the privacy of their social
media accounts.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">We don’t just post pictures of a great dinner we
prepared. We are more aggressive and
feel more free to say things on social media than we would face-to-face.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">So how do we get back to the social media of
yesteryear? How do we return to using
social media to promote, in our profession, evidence-based maternity care? <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
</div>
<ol>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Discern why <b><i>you</i></b> are on social media and be honest with
yourself.</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;"> </span><span style="font-family: "verdana" , sans-serif; font-size: x-small;">For me, it is an extension of
my childbirth education classes.</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;"> </span><span style="font-family: "verdana" , sans-serif; font-size: x-small;">It is
also a way to market my business and currently, promote an organization for
which I volunteer. A side benefit is to keep in contact with friends.</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;"> </span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Remember that social media is a <i><b>tool</b></i> or teaching strategy
just like a pelvic model or chart.</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;"> </span><span style="font-family: "verdana" , sans-serif; font-size: x-small;">It is
a device that we use with which to teach.</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Use the “unfollow” option to limit the number of aggressive posters
on your feed.</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;"> </span><span style="font-family: "verdana" , sans-serif; font-size: x-small;">You do not have to
unfriend them, just unfollow them if their posts are not something that you
want to see.</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Regardless of how you access social media, remember there is
always the option to not be active on social media.</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;"> </span><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Often, we can access social media through a
computer, smart phone or tablet.</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;"> </span><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Is that
too much?</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;"> </span><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Do you receive push
notifications that prompt you to engage?</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;">
</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Then turn off the notifications or limit social media time to one
device.</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Go “dark”.</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;"> </span><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Take a
break of 2-3 days.</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;"> </span><span style="font-family: "verdana" , sans-serif; font-size: x-small;">This can happen
around a holiday, weekend or anytime!</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;">
</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;">While you may find a drop in the endorphin/dopamine rush that happens
when someone “likes” your status, it may also drop your stress level and allow
you to regroup and think about other aspects of your life.</span></li>
</ol>
<br />
<br />
<div class="MsoNormal">
<o:p></o:p></div>
Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com1tag:blogger.com,1999:blog-38883909.post-31269839839612630022016-06-15T09:18:00.003-07:002016-06-15T09:27:50.110-07:00Why is complementary and alternative medicine (CAM) called complementary and alternative medicine when in reality, it came before western medicine?<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">In doing research for a new book, I asked myself the above
question. So why is CAM or complementary
and alternative techniques (CAT) called <i>alternative</i>? One website stated because CAM or CAT fall
outside of the realm of conventional medicine.
CAM/CAT complements traditional or western medicine. Wait.
If many of the components of CAM/CAT came before western medicine, then
shouldn’t CAM/CAT actually be the traditional medicine and western medicine be
viewed as an alternative?<o:p></o:p></span><br />
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">According to the Mayo Clinic, complementary medicine means that it is used along with conventional medicine. Alternative indicates that it is a therapy used in place of conventional medicine. Often they are used interchangeably. Integrative medicine uses the best of conventional medicine and the best of CAM/CAT. My best researched guess is that conventional medicine is that which has been developed mostly since WWI, including surgeries, radiation and prescription medication and treatments given by physicians and nurses in hospital settings.</span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">Some health care professionals and researchers state that CAM/CAT
results are difficult to </span></div>
<div class="separator" style="clear: both; text-align: center;">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><a href="https://1.bp.blogspot.com/-cKUB_X1bdCc/V2F_rm_ndBI/AAAAAAAADUU/roVVnwVIg1IC9MNgMZ7M6Crf31Wgk4XlQCLcB/s1600/lavender.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="135" src="https://1.bp.blogspot.com/-cKUB_X1bdCc/V2F_rm_ndBI/AAAAAAAADUU/roVVnwVIg1IC9MNgMZ7M6Crf31Wgk4XlQCLcB/s200/lavender.JPG" width="200" /></a></span></div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">ascertain.
They are difficult to study. So
the outcomes of CAM/CAT are questionable.
Websites such as Quackwatch credit the “popularity” of CAM/CAT to the
placebo effect. <o:p></o:p></span><br />
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">Articles claim that there is little research on why or how
patients decide to use CAM/CAT or how they access information about CAM/CAT. Let’s examine this statement. To begin with, not all who research CAM/CAT
are “patients” – they are people who are looking for a general alternative to
costly medical procedures or prescription medications that have profound side
effect. Second, it is no mystery how
individuals decide to use CAM/CAT or access information! In general, I would say that those who have
done their homework by reading books, magazines or internet research on CAM/CAT
use CAM/CAT because they are trying to seek a more gentle solution before
catastrophic surgeries, medical procedures or medications. Let’s face it, simply by listening to a
random commercial for medication on television sounds ominous.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<i><span style="font-family: "verdana" , sans-serif; font-size: x-small;"><b>Editor's Note: the following italicized paragraph is satire.</b></span></i></div>
<div class="MsoNormal">
<i><span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></i></div>
<div class="MsoNormal">
<i><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Ask your doctor if (insert
name of drug)is right for you! Side effects
can include acne, stomach upset, diarrhea, constipation, headaches, muscle
pain, dizziness, nausea, weight gain,
weight loss, hair loss, stuffy nose, sneezing, sore throat, memory problems,
hypertension, hypotension, blurred vision, painful erection, erections lasting 4 or more hours, fast heartbeat,
slow heartbeat, irregular heartbeat, drowsiness, sweating, dry mouth or sudden
death.<o:p></o:p></span></i></div>
<div class="MsoNormal">
<i><span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></i></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">By now, you are probably wondering what would be on the list
of CAM/CAT. CAM/CAT can include
acupuncture, aromatherapy, biofeedback, chiropractic, herbs, homeopathy,
hypnosis, massage therapy, meditation, naturopathy, osteopathic manipulative
therapy, Qi gong, reiki, spiritual healing, Tai Chi, traditional Chinese
medicine and yoga. Generally speaking,
each CAM/CAT seeks to see people as whole beings, not a malady or
malfunctioning area of the body. CAM/CAT examines the mind-body-spirit
connection and offers appropriate support.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><a href="http://www.hopkinsmedicine.org/healthlibrary/conditions/complementary_and_alternative_medicine/types_of_complementary_and_alternative_medicine_85,P00189/">Johns Hopkins </a>states that nearly 40% of US adults and 12% of
children use CAM/CAT. The National Institutes of Health created the
National Center for Complementary and Alternative Medicine to promote research
in the area of CAM/CAT and efficacy. In a recent survey, Americans reported
spending $33.9 billion (yes, billion with a “b”) out-of-pocket for practices
and products. Clearly, the American
public is looking for alternatives to what they are routinely exposed to by
western medicine.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">The demographics of childbearing families are no
different. They, too, are doing their
research on non-pharmacologic pain relief options for labor and birth. More and more expectant women are examining
the side effects of medications offered for labor and birth and systematically
rejecting them for other options. Childbirth
educators and doula must become familiar with CAM/CAT used in maternity care
and be ready to refer to more knowledgeable resources in their community. The fact is that our clients will be seeking CAM/CAT
practitioners and resources and we need to be aware and support our clients in
finding reputable and safe practitioners and resources.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">Below are some helpful resources for childbirth educators
and doulas wanting to know more about CAM/CAT:<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">National Institute of Health <a href="https://nccih.nih.gov/health/integrative-health">https://nccih.nih.gov/health/integrative-health</a><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">American Holistic Nurses Association <a href="http://www.ahna.org/">http://www.ahna.org/</a> <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">Pregnancy Birth & Beyond Australia <a href="http://www.pregnancy.com.au/pregnancy-information/natural-pregnancy/womens-use-of-complementary-and-alternative-therapies-during-pregnancy.shtml">http://www.pregnancy.com.au/pregnancy-information/natural-pregnancy/womens-use-of-complementary-and-alternative-therapies-during-pregnancy.shtml</a>
<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">Perinatal Education Associates, Inc. <a href="http://www.birthsource.com/scripts/article.asp?articleid=138">http://www.birthsource.com/scripts/article.asp?articleid=138</a></span></div>
<div class="MsoNormal">
<span style="font-size: x-small;"><span style="font-family: "verdana" , sans-serif;">BabyCentre UK </span><a href="http://www.babycentre.co.uk/a1027876/complementary-therapies-for-labour-pain" style="font-family: Verdana, sans-serif;">http://www.babycentre.co.uk/a1027876/complementary-therapies-for-labour-pain</a></span></div>
<div class="MsoNormal">
<o:p></o:p></div>
Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-8881455337116178322016-06-08T06:40:00.002-07:002016-06-08T06:40:11.263-07:00Guest Blogger Janice Banther: Who Is the Most Important Person in the Room?<span style="font-family: Verdana, sans-serif; font-size: x-small;"><b><i>Childbirth Today welcomes guest blogger, Janice Banther. Janice is the Executive Director of Birth Behind Bars, a pioneer organization caring for pregnant inmates. Janice founded BBB in 2001, as an inmate program in two jails in Tampa Bay, FL. Janice has helped birth professionals start their own inmate programs in several states.</i></b></span><br />
<br />
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">Not too long ago, we had a very
interesting birth. Actually, all of the births are interesting and you never
know what new protocol has been instituted at the hospital regarding inmates.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">Many times, the inmate is not taken to
the hospital where we usually go for their births. An ambulance is only called
for them if the Nurse in the Medical Department of the jail is concerned about
getting her to the hospital in time. Normally, they go in a squad car with the
Deputy. Understandably, taking an inmate out of the jail and into an unsecured
environment is a safety risk for everyone involved.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;"><br /></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">If the inmate goes by ambulance, the
EMT’s can make a decision to go to a closer hospital. This can become
interesting if we, the doulas, have not been told of a hospital change. In this
case we do a lot more driving trying to find our mom!<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;"><br /></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">Recently, one of our doulas did the
“find the right hospital” in the early morning light. After she got there, the
inmate was so relieved to see her. She was afraid that the doula would not know
which hospital to go to. Thankfully, she was there and was able to support her.
The inmate was precious in her very fast birth. Heather, the doula, was
stroking the inmate’s shoulder. The inmate put her hand up as if to say stop
touching me. Heather apologized and the inmate said, “No! I want you to keep
doing that.” Heather put her hand back on her shoulder. The inmate reached up
with her hand and then tilted her head as if she was trying to get even closer
to Heather’s hand.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;"><br /></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">For many inmates the comforting touch
of a doula is the only nonviolent contact they have experienced in months. Many
are coming from less than steady relationships on the outside.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">After the birth, if the mom is addicted
to drugs, then time is spent waiting to see how the baby reacts to being out of
the womb and not having drugs going into their system. There is a procedure the
nurses do each hour to test how baby is doing. At a certain point, in all cases
of addicted babies, they are taken to NICU so they can be monitored more closely.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">This mom was addicted to drugs. She
cried and held her baby tight. She kept apologizing to the baby for taking the
drugs and making him sick. It is not as if they found out they were pregnant
and then started taking drugs. They were addicted long before they were
pregnant. Just as any disease, addiction is very hard on the body, the baby,
and extremely hard to stay clean. This is not an excuse; it is the facts of
this terrible disease.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;"><br /></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">The baby did end up having to go to
NICU. Before Heather left, she could see the signs in the baby that he was now
feeling the effects of not having the drugs in his system. This is a radical
departure from what the baby had been experiencing in the mother’s womb.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;"><br /></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">So, why my question, WHO IS THE MOST
IMPORTANT PERSON IN THE ROOM? In this case, because of some confusion, the
hospital staff was not sure about when to take the mom to NICU to see her baby
and how many times they could. By this time there was a new doula that was now
working with the inmate postpartum, everything is different from the protocol
we are accustomed to. And we are in a hospital that we rarely go to.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;"><br /></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">The doula, Cheryl, was texting me
asking questions on certain policies and what the procedure would be. It was at
this time I learned a very valuable lesson. Everyone wants the best for the mom
who is an inmate. You, as the doula want the best, and also the hospital wants
the best for their patient (the inmate) and now their new patient, the baby.
But many times things do not turn out the way you as the doula want them.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;"><br /></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">Being a doula, and “standing your
ground” and saying I will not be moved and I want Plan A to be done NOW does
not help the inmate who is the mother. The most important person you are
working with in the room is the nurse. She is doing her job. She is the medical
professional on scene. There may not be a written policy for inmates. The
nurses can also be questioning what to do too.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;"><br /></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">In situations like this, instead of
“standing your ground” and saying it WILL be Plan A, work WITH the nurse and
the staff, not against them. You want to let them know that you recognize they
want what is best in this situation and you want to help them and the new
mother with this plan.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;"><br /></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">It is at this point, if you fight to
get your way with the hospital you may loose your right to be a doula and to
help her. Remember why are you there. It’s to help the mother, the inmate. To
help her bond with her new baby. To help this baby get the best start in life.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">If you spend this time fighting, and
loose the privilege of being with the inmate, who will be there for the next
inmate that is giving birth? That is the question you need to ask yourself.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">We have found that many times, that if
we don’t try to change the policy of the jail or the hospital, just our
presence alone has changed many different situations and policies. I believe
this is the reason why the jail we work with and the hospital and caregivers,
have been more on the cutting edge of incarceration reform than many other
institutions in the county.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">Care for the mother first. You will be
surprised how much you can influence the circumstances around you.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;"><br /></span></span></div>
<br />
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span style="font-size: x-small;">****Disclaimer: This blog is from the
perspective of a jail, not a State or Federal prison. Protocol will vary from
initiation to institution.</span><span style="font-size: 10pt;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<br /></div>
<div class="MsoNormal" style="vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif; font-size: x-small;">You can contact Janice at <a href="mailto:janice@janicebanther.com">Janice@janicebanther.com</a>. </span></div>
Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-12557691055205427502016-06-03T06:44:00.003-07:002016-06-03T13:17:36.327-07:00Eating Our Young, Chewing on Each Other – Call It What It Is <div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">This is not an evidence-based research blog entry. Today, I am writing some personal
reflections. And while I know it may not
be as riveting as an article about pregnancy, birth or breastfeeding, in a way –
it is about pregnancy, birth and breastfeeding.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">All too frequently these days I hear stories of maternity
care professionals….. PROFESSIONALS…..berating younger professionals, and
humiliating peers. Hey, let’s be clear.
It’s all bullying. Yes, BULLYING. Call it what it is. It is being cruel in order to really hurt
someone.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">And also, let me define maternity care professionals. They are doctors, nurses, childbirth educators,
doulas, lactation professionals -
basically anyone who provides any type of service </span></div>
<div class="separator" style="clear: both; text-align: center;">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><a href="https://1.bp.blogspot.com/-cbQtg57n1bc/V1GJeLKCACI/AAAAAAAADUA/PQsy97RWnWM-pjQ0a3SQbGu3epOaTpMsgCLcB/s1600/angry%2Bemoji.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://1.bp.blogspot.com/-cbQtg57n1bc/V1GJeLKCACI/AAAAAAAADUA/PQsy97RWnWM-pjQ0a3SQbGu3epOaTpMsgCLcB/s200/angry%2Bemoji.JPG" width="190" /></a></span></div>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">to childbearing families.<o:p></o:p></span><br />
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">Let’s break this down.
You work in maternity care. By
definition, you are welcoming a new human being to the planet. You are assisting in a miracle. When we work in maternity care and spend a
lot of time harassing or bullying another co-worker, you are taking time and
brain power away from the work we are called to do. This interferes with care.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">Another way to look at it.
You are a professional. Does
cruelty to a peer or bullying sound like professional behavior? No?
<i><u>Then just stop it.</u></i><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">If a younger maternity care professional cannot perform, ask
yourself if their orientation was enough for them. It may have been the standard orientation,
but all humans are not created equal so this younger person may need more
nurturing and mentoring.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
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<span style="font-family: "verdana" , sans-serif; font-size: x-small;">If a peer seems distracted or not as on-point as usual,
instead of swinging immediately into attack mode, perhaps come along side of
them and find out if there is another reason for the behavior. Let them know gently that they have lost
their edge and may need to step back and reevaluate. Be ready to give them sources of support –
even you.<o:p></o:p></span></div>
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<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
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<span style="font-family: "verdana" , sans-serif; font-size: x-small;">Bullying can be vertical (where a manager bullies someone
under his/her supervision) or horizontal (where maternity care professionals bully their colleagues).<o:p></o:p></span></div>
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<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
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<span style="font-family: "verdana" , sans-serif; font-size: x-small;">And basically if you are a bully, you don’t need to be in
the maternity care field. For that
matter, why are you in health care?<o:p></o:p></span></div>
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<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
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<span style="font-family: "verdana" , sans-serif; font-size: x-small;">The American Nurses Association reports that between 18-31%
of all nurses have encountered bullying in the workplace. And there may be more who have not reported.<o:p></o:p></span></div>
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<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></div>
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<span style="line-height: 115%;"><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Jennifer Larson, contributor to nursingjobs.com says,<i> “Like schoolyard bullying, workplace
bullying involves a real or perceived imbalance of power and repetition of the
negative behavior. The behavior can be
over, such as yelling or threatening, or it can be more insidious and passive,
like refusing to cooperate or perform necessary tasks.” </i>She goes on to note<i>, “Bullying can also result in harm to patients. In a 2008 Sentinel Alert that addressed
disruptive behavior. The Joint Commission noted that “intimidating and
disruptive behaviors can foster medical errors and (lead) to preventable
adverse outcomes.”<o:p></o:p></i></span></span></div>
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<span style="line-height: 115%;"><span style="font-family: "verdana" , sans-serif; font-size: x-small;"><i><br /></i></span></span></div>
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<span style="line-height: 115%;"><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Additionally, in 2009, The Joint Commission began requiring
that organizations establish a code of conduct that defines and distinguishes
acceptable and unacceptable behaviors to maintain their accreditation. This was
too little too late for many.<o:p></o:p></span></span></div>
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<span style="line-height: 115%;"><span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></span></div>
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<span style="line-height: 115%;"><span style="font-family: "verdana" , sans-serif; font-size: x-small;">But what if you are an independent childbirth educator or
doula or other birth professional. Think you are exempt from
bullying? Far from it. However, be aware
of the Grievance Policies that are in place in the various certifying
organizations. You may be pleased to
find that international and national organizations have very little patience
with true bullying.<o:p></o:p></span></span></div>
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<span style="line-height: 115%;"><span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span></span></div>
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<span style="line-height: 115%;"><span style="font-family: "verdana" , sans-serif; font-size: x-small;">The final question may be: what do I do if I am being
bullied by someone not affiliated with a hospital or organization with a
grievance policy. Here are five steps
that I’ve found helpful:<o:p></o:p></span></span></div>
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</div>
<ol>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small; line-height: 115%;">Don’t react to them.</span><span style="font-family: "verdana" , sans-serif; font-size: x-small; line-height: 115%;">
</span><span style="font-family: "verdana" , sans-serif; font-size: x-small; line-height: 115%;">This is so very difficult but if you do react, you give them fuel to
keep going.</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small; line-height: 115%;">Have 1-2 people in the “business” in whom you can confidentially confide.</span><span style="font-family: "verdana" , sans-serif; font-size: x-small; line-height: 115%;"> </span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small; line-height: 115%;">Be aware of your behavior.</span><span style="font-family: "verdana" , sans-serif; font-size: x-small; line-height: 115%;">
</span><span style="font-family: "verdana" , sans-serif; font-size: x-small; line-height: 115%;">Again, don’t give them something to use against you.</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small; line-height: 115%;">Give it time.</span><span style="font-family: "verdana" , sans-serif; font-size: x-small; line-height: 115%;"> </span><span style="font-family: "verdana" , sans-serif; font-size: x-small; line-height: 115%;">Lots of
time. If you don’t react, they’ll lose interest.</span><span style="font-family: "verdana" , sans-serif; font-size: x-small; line-height: 115%;"> </span><span style="font-family: "verdana" , sans-serif; font-size: x-small; line-height: 115%;">This is often easier said than done.</span></li>
<li><span style="font-family: "verdana" , sans-serif; font-size: x-small; line-height: 115%;">Find delight in karma.</span></li>
</ol>
<br />
<br />
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<o:p></o:p></div>
Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-79385626222785843732016-05-23T09:44:00.000-07:002016-05-23T09:44:22.983-07:00Summer Reading Suggestion: Cut It Out, the C-section Epidemic in America<span style="font-family: "verdana" , sans-serif; font-size: x-small;">I</span><span style="font-family: "verdana" , sans-serif; font-size: x-small;">t is summer time and you may be looking for a good book to read. Like many birth professionals, you may want to stick with a specific genre - birth. So here is a good....not GREAT book to consider for your summer reading time. It is a page turner. Yes, it's THAT good.</span><br />
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: "verdana" , sans-serif; font-size: x-small;">I did write about this book in 2013 when it was first released but feel that even now, there are valid points to be made. </span><span style="font-size: x-small;"><em><span style="background: white; color: #333333; font-family: "verdana" , "sans-serif";">Cut It Out </span></em><span style="background: white; color: #333333; font-family: "verdana" , sans-serif;">examines
the exponential increase in the United States of the </span></span><br />
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<span style="font-size: x-small;"><a href="https://4.bp.blogspot.com/-qid0XvECXgc/V0MUxXX3FlI/AAAAAAAADTo/lHwv1pEcnbouZoGL5m-MxJae_KMjcnDKQCLcB/s1600/cut%2Bit%2Bout1.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="https://4.bp.blogspot.com/-qid0XvECXgc/V0MUxXX3FlI/AAAAAAAADTo/lHwv1pEcnbouZoGL5m-MxJae_KMjcnDKQCLcB/s320/cut%2Bit%2Bout1.JPG" width="206" /></a></span></div>
<span style="font-size: x-small;">most technological form of
birth that exists: the cesarean section. While c-section births pose a higher
risk of maternal death and medical complications, can have negative future
reproductive consequences for the mother, increase the recovery time for
mothers after birth, and cost almost twice as much as vaginal deliveries, the
2011 cesarean section rate of 33 percent is one of the highest recorded rates
in U.S. history, and an increase of 50 percent over the past decade. Further,
once a woman gives birth by c-section, her chances of having a vaginal delivery
for future births drops dramatically. This decrease in vaginal births after
cesarean sections (VBAC) is even more alarming: one third of hospitals and one
half of physicians do not even allow a woman a trial of labor after a
c-section, and 90 percent of women will go on to have the c-section surgery
again for subsequent pregnancies. Of comparative developed countries, only
Brazil and Italy have higher c-section rates; c-sections occur in only 19% of
births in France, 17% of births in Japan, and 16% of births in Finland.</span><br />
<span style="font-size: x-small;"><span style="background: white; color: #333333; font-family: "verdana" , sans-serif;"><br /></span></span>
<span style="color: #333333; font-family: "verdana" , sans-serif; font-size: x-small;"><span style="background-color: white;">Author Theresa Morris systematically examines the reasons for the epidemic rise in cesareans as four pronged: <b>women know very little about labor and birth</b> and do not have complete access to unbiased, evidence-based information. The co-optation of childbirth classes in the 1980s is the reason for this. Yes, it may have been a "good idea" at the time to have childbirth classes move from the community to the hospital, but what many authors of the time feared would happen, has happened: hospital based childbirth classes, generally, are a commercial for what can be expected at that facility. Few mention broad options for childbirth, non-pharmacologic pain relief methods or informed decision making. Secondly, <b>care providers are constrained </b>by their tunnel-vision training and/or their employer's risk management rules and do not or can not practice evidence-based care. Thirdly, <b>organizations take an inordinate amount of time to change policies</b>, procedures and practice guidelines. This encompasses ACOG and hospitals. And finally, we live in such a<b> litigious society </b>that this hinders any type of movement forward in evidence-based quality of maternity care.</span></span><br />
<span style="color: #333333; font-family: "verdana" , sans-serif; font-size: x-small;"><span style="background-color: white;"><br /></span></span>
<span style="color: #333333; font-family: "verdana" , sans-serif; font-size: x-small;"><span style="background-color: white;">Morris points out that if our intervention rate (including cesarean sections) is rising, the maternal/infant mortality/morbidity rate should be dropping. It isn't. In other words, the more that is done to women, more mothers and babies are dying in America. But Morris doesn't leave you stranded. She thoughtfully points out a road map for change.</span></span><br />
<span style="color: #333333; font-family: "verdana" , sans-serif; font-size: x-small;"><span style="background-color: white;"><br /></span></span>
<span style="color: #333333; font-family: "verdana" , sans-serif; font-size: x-small;"><span style="background-color: white;">I suggest we all get on the road to change.</span></span><br />
<span style="color: #333333; font-family: "verdana" , sans-serif; font-size: x-small;"><span style="background-color: white;"><br /></span></span>
<span style="color: #333333; font-family: "verdana" , sans-serif; font-size: x-small;"><span style="background-color: white;">"Cut it Out: The C-Section Epidemic in America" is available through Amazon. Hardcover is $30 but for those of us who don't like to wait, it is $9.99 on Kindle. Happy reading!</span></span><br />
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Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-6895296086301426912016-05-16T06:33:00.004-07:002016-05-16T06:36:18.186-07:00HG Awareness Day ~ May 15....and every day!<div class="separator" style="clear: both; text-align: center;">
<a href="https://3.bp.blogspot.com/-rHuhwEx7Ll4/VznLH8uOVdI/AAAAAAAADTM/Eq4Zx8A_2MQR6J-cluSV4m086uUmNG-RACLcB/s1600/Hyperemesis%2Bawareness%2Bday.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="70" src="https://3.bp.blogspot.com/-rHuhwEx7Ll4/VznLH8uOVdI/AAAAAAAADTM/Eq4Zx8A_2MQR6J-cluSV4m086uUmNG-RACLcB/s320/Hyperemesis%2Bawareness%2Bday.JPG" width="320" /></a></div>
<br />
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<span style="font-family: "verdana" , "sans-serif"; font-size: 10.0pt; line-height: 115%;"><b><i>Hyperemesis Gravidarum Awareness Day was Sunday May 15. </i></b></span></div>
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<span style="font-family: "verdana" , "sans-serif"; font-size: 10.0pt; line-height: 115%;"><b><i>However, it should be EVERY day!</i></b></span></div>
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<span style="font-family: "verdana" , "sans-serif"; font-size: 10.0pt; line-height: 115%;">In 1979, a young twenty-three year old was expecting
her first child. During her first
trimester, she experienced the typical morning sickness. At the cusp between second and third
trimester, this young woman developed severe nausea and vomiting. The severity was overwhelming to the point
that she had to bring a “barf bag” with her wherever she went. When she (a med-surg nurse) brought it to her
obstetrician’s attention, he turned a blind eye, said hyperemesis gravidarum
didn’t really exist, it was all in her head and handed her “water pills” to
relieve the pitting edema in her calves, ankles and feet. Fortunately, this young woman gave birth
vaginally and had a healthy baby girl.
However, on the day of discharge from the hospital, her obstetrician
told her that she would not be able to breastfeed because the water pills had
dried up all of her milk.<o:p></o:p></span></div>
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<span style="font-family: "verdana" , "sans-serif"; font-size: 10.0pt; line-height: 115%;"><br /></span></div>
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<span style="background: white; font-family: "verdana" , sans-serif; font-size: 10pt; line-height: 115%;">According
to Medscape, hyperemesis gravidarum (HG) is the most severe form of nausea and
vomiting in pregnancy, characterized by persistent nausea and vomiting
associated with ketosis, dehydration and weight loss (>5% of prepregnancy
weight). This condition may cause volume depletion, electrolytes and acid-base
imbalances, nutritional deficiencies, and even death. Severe hyperemesis
requiring hospital admission occurs in 0.3-2% of pregnancies.</span><o:p></o:p></div>
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<span style="background: white; font-family: "verdana" , sans-serif; font-size: 10pt; line-height: 115%;"><br /></span></div>
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<span style="background: white; font-family: "verdana" , sans-serif; font-size: 10pt; line-height: 115%;">The
HER Foundation (Hyperemesis Education & Research Foundation:
www.helpher.org) is a non-profit organization that has been dedicated to HG
support, education, research and advocacy since 2003. The HER Foundation says there is no clear
etiology for HG and it could even be due to multiple causes. When first
recognized several centuries ago, HG was thought to be caused by toxins,
ulcerations or an infection. In the 20<sup>th</sup>
century it was decided that HG was a psychological condition. Today, lab tests can be done to confirm
hyperemesis gravidarum. These tests
include urinalysis for ketones and specific gravity, serum levels of electrolytes
and ketones, TSH and free T, and hematocrit levels to name a few. <o:p></o:p></span></div>
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<span style="background: white; font-family: "verdana" , sans-serif; font-size: 10pt; line-height: 115%;"><br /></span></div>
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<span style="background: white; font-family: "verdana" , sans-serif; font-size: 10pt; line-height: 115%;">The
only FDA approved drug for treating nausea and vomiting in pregnancy is
pyridoxine or Vitamin B6. Herbals such
as ginger may also be helpful, but not in all cases. In severe cases, antiemetics, corticosteroids
or antihistamines may also be used. Nutritional
supplementations either by IV or directly into the GI system may help with
nutritional deficiencies.<o:p></o:p></span></div>
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<span style="background: white; font-family: "verdana" , sans-serif; font-size: 10pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="background: white; font-family: "verdana" , sans-serif; font-size: 10pt; line-height: 115%;">There
are several handouts available from the HER Foundation and the University of
Southern California:<o:p></o:p></span></div>
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<span style="background: white; font-family: "verdana" , sans-serif; font-size: 10pt; line-height: 115%;"><br /></span></div>
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<span style="background: white; color: #674ea7; font-family: "verdana" , sans-serif; font-size: 10pt; line-height: 115%;"><a href="http://www.helpher.org/PressCenter/presskit/poster-Symptomatology-and-Outcomes.pdf"><b>Symptomatology and Outcomes of Women with HG</b></a></span></div>
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<a href="http://www.helpher.org/health-professionals/diagnosis-assessment/index.php"><br /></a></div>
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<span style="font-family: "verdana" , "sans-serif"; font-size: 10.0pt; line-height: 115%;"><b><a href="http://www.helpher.org/health-professionals/diagnosis-assessment/index.php">Diagnostic and Assessment Tools</a></b></span></div>
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<br /></div>
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<span style="font-family: "verdana" , "sans-serif"; font-size: 10.0pt; line-height: 115%;"><a href="http://www.helpher.org/health-professionals/patient-education-tools.php"><b>Patient Education Tools</b></a><o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "verdana" , "sans-serif"; font-size: 10.0pt; line-height: 115%;"><a href="http://www.helpher.org/blog/wp-content/uploads/2013/09/HERBrochure.pdf"><b>The HER Informational Brochure</b></a><o:p></o:p></span></div>
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<br /></div>
<br />
<div class="MsoNormal">
<span style="background: white; font-family: "verdana" , sans-serif; font-size: 10pt; line-height: 115%;">Remember
that young nurse from 1979? She went on
to become a childbirth educator so that other mothers could be aware of
HG. She also successfully breastfed her
first baby, thanks to the local La Leche League. That young woman was me. <o:p></o:p></span></div>
Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-48396112348739575682016-05-10T15:24:00.001-07:002016-05-10T15:24:42.001-07:00Childbirth Today Vlog for May 10!In today's Vlog, we chatted about last week's <a href="http://wmmhday.postpartum.net/">Maternal Mental Health Day</a> and noted that former Postpartum Support International President Birdie Gunyon Meyer will be a guest on the May 24th show. She had trouble accessing the Vlog last week. <br />
<br />
We also talked about International Day of the Midwife May 5 and how a <a href="http://time.com/4318462/international-day-of-the-midwife/">Time Magazine article </a>written by the program officer of the Bill and Melinda Gates Maternal, Newborn and Child Health Foundation stated that midwives are essential to Global health. They are. The research shows it. Unfortunately, we are just slow in embracing this!<br />
<br />
Below is a portion of the interview with Jennifer Shryock, owner of <a href="http://familypaws.com/">Family Paws Inc.</a> and her discussion about integrating babies into families that already contain pets. Learn about Jennifer's upcoming speaking events and her international conference coming in July!<br />
<br />
It is only a partial interview as the Blab platform is a beta version and prone to glitches. It is also on my YouTube Channel (<a href="https://www.youtube.com/user/thebirthfacts">https://www.youtube.com/user/thebirthfacts</a>) - as are the other two interviews and shows plus much more! Enjoy!<br />
<br />
<br />
<br />
<iframe allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/P-nlDBMsaFE" width="420"></iframe>Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0tag:blogger.com,1999:blog-38883909.post-5589037576870165202016-04-27T12:36:00.001-07:002016-04-27T12:36:27.304-07:00What is a Doula? Watch this!<span style="font-family: Verdana, sans-serif; font-size: x-small;">Have you ever wanted to know about Doulas?<br /></span><br />
<span style="font-family: Verdana, sans-serif; font-size: x-small;">Have you ever needed a video to show potential clients?<br /></span><br />
<span style="font-family: Verdana, sans-serif; font-size: x-small;">This amazing video done by doula Amy Chavez is, well, perfect.<br /></span><br />
<span style="font-family: Verdana, sans-serif; font-size: x-small;">Take 20 minutes and enjoy!</span><br />
<br />
<br />
<br />
<br />
<iframe allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/v-eoENgKIHA" width="460"></iframe>Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com1tag:blogger.com,1999:blog-38883909.post-47238164218344177232016-04-26T12:18:00.000-07:002016-04-26T12:18:01.875-07:00Childbirth Today goes LIVE! Here's the show from April 26!<iframe allowfullscreen="" frameborder="0" height="480" src="https://blab.im/c6b01f672f884a409b64c58005534a90" width="540"> </iframe>
Anonymoushttp://www.blogger.com/profile/17137108291836090005noreply@blogger.com0