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Continuing Birth Education (Free Webinar Round Up)

I have a good friend who has become very interested in training as a doula. I love sharing information and resources with excited women new to the birth work field! It is rejuvenating and reminds me my own enthusiasm for women and birth. When I shared this same sentiment on Facebook a fan commented with this lovely observation: “Birth is an ever-evolving subject, and there are as many different ways to do it as there are fingerprints!! How could anyone get bored in the birth work field?? I love it!! It keeps me in the Presence of Now and reminds me of the Sacredness of Life…” 🙂

Anyway, I’ve been collecting books like crazy to lend to my friend (just a word: never ask me for a book about anything unless you are ready to be overwhelmed with options!) and doing so reminded me of some free webinars that have crossed my desk(top) recently as well as some other, older continuing education resources for birth professionals or aspiring birth professionals. I always go to books first and to written information. Love it. Can’t get enough words! But…many people learn better through other mediums. Here are some non-book, free possibilities for self-education in birth work:

Edited to add another free webinar from ICEA (with paid contact hour option) that I just learned about:

Prenatal Fitness Webinar
 Join us online 
 Thursday, December 13, from 9-10 pm EST for this new educational offering
worth 1.0 ICEA Continuing Education Credit!!
 
This offering is free for all participants to audit.
The continuing education credit may be purchased after viewing the webinar for $35.00 by clicking here!
Once the credit hour is purchased, print out your receipt for confirmation of your hour earned!

A reader also commented to share that she is enrolled in a free Coursera course on contraception (she also took one that looks great about community change in public health!). There are a variety of interesting looking courses available from well-known institutions in the Coursera offerings under Health & Society and Medical Ethics.

And, for those who do well with auditory learning, I have some podcast recommendations that are available on an ongoing basis:

La Leche League International offers a series of free podcasts, my favorites being:

And, the Motherlove blog has some awesome resources too, including:

And, finally there are some great free classes and certificate programs available from Global Health eLearning Center. Many are designed for global audiences and are not specifically geared toward doulas (or even midwives, but more of health workers in general). I particularly enjoyed this class: Healthy Timing and Spacing of Pregnancy

Enjoy! And, if you have favorite recommendations to add, please let me know! (free, please)

Due to reader request, a book recommendation post will soon follow! Past book recommendations can be seen in this post, as well as a postpartum list, and also in my book reviews section.

Breastfeeding Class Resources

I became certified as a breastfeeding educator in 2004 and accredited as a breastfeeding counselor in 2005, so I’ve been working with breastfeeding mothers for a long time. I lead a monthly support group and offer help/counseling via phone, email, text, Facebook message, Words with Friends messages, you name it. Recently, a nurse contacted me asking for ideas for teaching an early pregnancy breastfeeding class. I think this is a great idea, since mothers’ decisions about breastfeeding are often made before the baby is conceived and if not then, during the first trimester.

These are the initial ideas I suggested:

  • Focus on what the mothers themselves want—what do they need/want to know? What have they heard about breastfeeding? What are their fears? What misconceptions do they need cleared up? I’m very much about peer-to-peer support and allowing space for the women to talk to/connect with each other—the facilitator is then available to clear up misinformation and provide tips.
  • Focus on what mothers can do to prepare for successful breastfeeding—there is evidence that prenatal breast massage/colostrum expression helps with both milk supply AND with mother’s comfort with her own breasts. It also helps her think of herself as a breastfeeding mother BEFORE her baby is actually born!
  • Suggest good books to have on hand and encourage attending a breastfeeding support group (like LLL!) prior to baby’s birth.
  • Promote/discuss/encourage “baby led breastfeeding.” I love sharing with mothers about how smart their babies are and how mother’s chest after birth becomes baby’s new habitat! Check out the resources from Suzanne Colson: http://www.biologicalnurturing.com/
  • Discuss and emphasize all of the other great ways dads and other family members can be involved with baby other than giving a bottle. Dad/grandma can do EVERYTHING ELSE baby needs! That’s cool! Leave the feeding to mom and let dad have the other special and important jobs like baths and burping and tummy time and more.
  • DON’T talk about “myths” and try to dispel them in a myth-fact format, because evidence suggests that this actually helps the myths stick more!
  • Use Diane Wiessinger’s approach to language (http://www.motherchronicle.com/watchyourlanguage) i.e. breastfeeding isn’t a “special bond” it is a NORMAL bond. People want to be normal—special is for celebrities and “other people,” normal is what everyone wants. She also has handouts here: http://normalfed.com/Why.html

Since her email, a couple of other resources and bits have caught my eye. One is that the AAP has a resolution about the distribution of formula “gift bags” by pediatricians and hospitals. Apparently this came out in 2011, but it only came to my attention when I saw this image on Facebook!

In keeping with the 10 Steps and consistent with the AAP’s resolution, the hospital advocacy project from the Illinois State Breastfeeding Taskforce makes available the following useful documents for mothers to communicate with their hospitals:

The Task Force explains:

We encourage you to make the Breastfeeding Bill of rights and Hospital Experience Letters available to moms in your classes, practices, community events, breastfeeding fairs, “rock & rest” stations, etc.

Encourage moms to fill out the appropriate letter and mail back to the hospital where she delivered her baby.  Or collect the letters and mail them from your agency or task force.  Help moms make their voices heard!

We hope that this will show hospital administrators that lactation consultants, knowledgeable staff and breastfeeding friendly practices are valued by moms and families using their hospital services.

The Missouri Breastfeeding Coalition clued me into this Breastfeeding Plan for Mothers (pdf) from the MO Dept. of Health. The handout may be downloaded and printed as needed and is a, “list of requests that support breastfeeding for the postpartum stay. Similar to a birth plan and based on the 10 Steps for Breastfeeding.”

Also, make sure to check out this awesome resource, the WIC Sharing Gallery—free programs, curricula, brochures, and more from different WIC offices. I found this because I was back at the Illinois Breastfeeding Taskforce’s website downloading their Grandmother’s Tea curriculum for intergenerational support of breastfeeding.

Another great resource is the FREE online Tear-Sheet Toolkit from La Leche League.

And, finally, I already touched on this, but remember there are ample handouts/articles available from the incomparable Diane Wiessinger about birth and breastfeeding.

Active Birth in the Hospital

One of the inspiring images in ICAN of Atlanta's "Laboring on the Monitors" slideshow.

The vast majority of my birth class clients are women desiring a natural birth in a hospital setting. My classes are based on active birth and include a lot of resources for using your body during labor and working with gravity to help birth your baby. Sometimes I feel like active birth and hospital birth are incompatible—i.e. the woman’s need for activity runs smack dab into the hospital’s need for passivity (i.e. “lie still and be monitored”). So, I was delighted to discover this awesome series of photos from ICAN of Atlanta of VBAC mothers laboring on the monitors. It IS possible to remain active and upright, even while experiencing continuous fetal monitoring.

In my own classes, we talk about how to use a hospital bed without lying down—the idea that a hospital bed can become a tool you can use while actively birthing your baby. Here is a pdf handout on the subject:How to Use a Hospital Bed without Lying Down. In this handout, I offer these tips for using the bed as an active assistant, rather than a place to be “tied down”:

While being monitored and/or receiving IV fluids that limit mobility, try:

  • Sitting on a birth ball and leaning on bed
  • Sitting on bed
  • Sitting on bed and lean over ball (also on bed)
  • Kneeling on bed
  • Hands and knees on bed
  • Standing up and leaning on bed
  • Leaning back of bed up and resting against it on your knees
  • Bringing a beanbag chair, putting it on the bed and draping over it (can also make “nest” with pillows)
  • Partner sitting on bed and woman leaning on him/supported squats with him
  • Partner sitting behind woman on bed (with back leaned up as far as it will go)

While giving birth, try:

  • Hands and knees on bed
  • Kneeling with one leg up (on bed like a platform or “stage”)
  • Holding onto raised back of bed and squatting or kneeling
  • Squatting using squat bar

While most of the above tips can be used during monitoring, additional ideas for coping with a simultaneous need for monitoring AND activity include:

  • Kneel on bed and rotate hips
  • Sit on edge of bed and rock or rotate hips
  • Sit on ball or chair right next to bed (partner can hold monitor in place if need be)

If something truly requires being motionless, it can be helpful to have some breath awareness techniques available in your “bag of tricks.” One of my favorites is: Centering for Birth

Some time ago, a blog reader posed the question, can I really expect to have a great birth in a hospital setting? I definitely think it is possible! I also think there is a lot you can do in preparation for that great hospital birth! When planning a natural birth in the hospital, it is important to consider becoming an informed birth consumer. I always tell my clients that an excellent foundation for a simple, effective, evidence-based birth plan is to base it on Lamaze’s Six Healthy Birth Practices. My own pdf handout summarizing the practices is also available: Six Healthy Birth Practices. Don’t forget there is also a great video series of the birth practices in action! You might also want to get a copy of the book Homebirth in the Hospital. And, check out this post from Giving Birth with Confidence: Six Tips for Gentle but Effective Hospital Negotiations.

Before you go in to the hospital to birth your baby, make sure you have some ideas about this very popular question, how do I know if I’m really in labor?

And, finally, be prepared for the hospital routines you may encounter by reading my post: What to Expect When You Go to the Hospital for a Natural Childbirth.

For some other general ideas about active birth, read my post about Moving During Labor (written for a blog carnival in 2009).

Best wishes for a beautiful, healthy, active hospital birth! You can do it!

Six Healthy Birth Practices Handout

Lamaze’s Six Healthy Birth Practices are one of my favorites resources when discussing birth plans in my classes. I find that some materials about birth planning on the internet are unnecessarily cumbersome (while simultaneously being very “cookie cutter”). As I tell my clients, the Six Healthy Birth Practices provide an absolutely phenomenal “basic” birth plan and concisely cover each element of a healthy birth. I suggest using them as a foundation for any birth plan the client plans to write. For use in my own classes, I created a one page handout briefly summarizing the practices: Six Healthy Birth Practices. At the bottom of the handout, I also include my own even simpler summary of the information. I just love them and think they should be the core of any class that serves women planning hospital births. Seriously, what women deserve in a birth environment can be summed up in six, clear sentences! How practical.

I also absolutely LOVE the video based on the practices that is available from Injoy. It is extremely affordable (I actually own three copies of it!). It is very concise and clear (just like the practices themselves) and I love how it shows women in a hospital environment, getting their needs met and having satisfying births. While I personally choose homebirth for myself and am a big advocate of homebirth, at least 90% of my clients are planning hospital births and deserve information and resources that support healthy, satisfying births in the environment they have chosen. I have a variety of great videos in my library, but many of them focus on homebirth and I think the message this sends to clients is—“good birth = homebirth.” While that feels personally true for me, it isn’t actually the message I want to share with my clients—I want to share my enthusiasm for birth, period, and to help them discover resources and plans for having a beautiful birth in any setting. I want to communicate to them that they deserve access to these healthy birth practices in the hospital and I hope we can create a birthing world in which all women can expect to have access to these practices in any setting. So, I like how this video shows women getting their needs met within in a hospital setting.

Additionally, the videos are available for free, practice by practice, on the Mother’s Advocate site, which also includes a variety of accompanying handouts to print.

And, again, here is my own handout for use during birth classes: Six Healthy Birth Practices.

I know I sound like a “commercial” for Lamaze’s Birth Practices and though I am a Lamaze member, I am actually certified with other organizations (ICEA and CAPPA). I think it is important that childbirth educators not limit themselves only to the materials and information provided by their own certifying organization and instead seek out excellent materials from a variety of the wonderful organizations that exist to support birthing women!

Handouts for Birth Booths

A frequent topic on email lists for birth professionals is good handouts/resources for booths at maternity or baby fairs. Rather  than making copies of materials or creating my own handouts (reinventing the wheel in a less-professional looking way!),  I am a fan of using glossy, professionally printed, but still very low cost stuff for tables and also a fan of materials that address good maternity care in general. My top faves for having on a booth or as handouts are:

Fathers, Fear, and Birth

“I told my dads that they were their partner’s lover and that their most important role at the birth was one they did everyday without classes, books or practice: Loving the mom. You could literally see the dads relax as this thought sunk in and took root.”

~ Lois Wilson, CPM

My husband supports me during my birthing time with our second baby

I don’t use these exact words, but I share something similar with the dads in my classes—your most important job is just to love her the way you love her, not to try to be anything different or more “special” than you already are…

I recently shared my review of The Father’s Home Birth Handbook by Leah Hazard and also wanted to share this excerpt from an article in Midwifery Today:

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Helping Men Enjoy the Birth Experience, by Leah Hazard

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Nearly 70 years ago, Grantly Dick-Read wrote in Childbirth without Fear that laboring women often experience a cycle of: Fear > Tension > Pain. This is a cycle with which many of us are familiar, and we’ve developed a myriad of ways to break the cycle since Dick-Read first published his seminal work in 1942. However, less attention has been focused on the emotional roller-coaster fathers experience throughout pregnancy and birth, and it’s this area that I’d like to explore in greater depth.

Although a man cannot feel the same pain as a laboring woman, I believe that many men experience a similar cycle of emotions in the birthing space to that which Dick-Read described, with a slightly different end product, namely: Fear > Tension > Panic. A man who is not confident in his partner’s birthing abilities, who is poorly informed, and/or who is poorly supported, becomes increasingly tense; and if this tension is not eased, then he spirals into an irreversible state of panic. This panic manifests differently in different men: some men become paralyzed by their fear (the familiar specter of the terrified dad sitting stock-still at the foot of the bed), while others spring into hyperactivity, bringing endless cups of water or becoming obsessively concerned with the temperature of the birth pool.

The root of this panic is fear, and it’s a fear which often begins to grow long before the first contraction is felt. As such, we need to think about ways that we can address and minimize this fear in the days and months preceding birth…

[Please read the rest of this article excerpt in the full online version of E-News: http://www.midwiferytoday.com/enews/enews1221.asp ]

Excerpted from “Beyond Fear, Tension and Panic: Helping Men Enjoy the Birth Experience,” Midwifery Today, Issue 95 Author Leah Hazard is the author of The Father’s Home Birth Handbook. For more information, visit www.homebirthbook.com .

——

I really think the fear-tension-panic cycle makes a great deal of sense and it brought me to this quote:

“Fear is completely intertwined with what we experience as labor pain…And it is the fear in our physicians and nurses as much as the fear within ourselves.” –Suzanne Arms (Immaculate Deception II)

I think sometimes women underestimate the power the attitudes of other people in the birthplace hold over outcome (the nocebo effect, possibly)—while being prepared, confident, fearless, etc. as a birthing woman is excellent and she can sometimes manage to triumph over the fear of the others around her, I more often see the fear of others overriding the preparation and confidence a mother has tried to develop in herself. I think it is important that we actively cultivate coping skills and resources within fathers-to-be as well, so that they are less likely to get into the fear-tension-panic cycle and are better able to be present for the birthing woman (fear-tension-panic within doctors and nurses is a subject for another post!). Here are some other posts I’ve written specifically for fathers:

Ideas for supporting your partner in labor

No Right Way

Resources for Fathers to Be

Birth Affirmations for Fathers

For Labor Support Remember TLC or BLT

Comfort Measures & Labor Support Strategies

Helping yourself while helping your wife or partner in labor

(P.S. Yesterday this was a much more developed post and WordPress erased it accidentally and to my great dismay 😦 )

Prematurity Awareness Month: Mind/Body Medicine in the NICU

November is Prematurity Awareness Month and I’m pleased to have a guest post from OB/GYN and author, Dr. Jennifer Gunter, about prematurity and “mind-body medicine in the NICU.”

Mind-Body Connection

The mind-body connection is the idea that our thoughts and emotions impact our health. When we are stressed, anxious, or depressed our brain releases different combinations of chemicals and hormones that affect every organ system. Because mom and baby share a physical bond before birth as well as close emotional bond after birth, the mind-body connection is very important both during pregnancy and after delivery.

Studies show depression, stress, and anxiety during pregnancy increase the risk of preeclampsia (high-blood pressure) and premature delivery and can also lead to smaller babies. The American Congress of Obstetricians and Gynecologists recommends routine screening for depression as 14-23% of pregnant women are affected. There are many treatment options and getting help can improve your baby’s health. Remember, if you feel better it will benefit your baby.

It is intuitive that a mother’s emotional health can affect her pregnancy. After all, there is an intimate and prolonged physical connection. But how can this be the case after delivery? Have you ever been in a room with an anxious person or someone who is very depressed and felt your mood change? Our moods are influenced by the emotions of others and this is especially true with a mother and her newborn. When a mom is stressed, her baby is more likely to have abnormal levels of stress hormones. Some of the physical effects of mom’s (and dad’s too) stress on baby include increased colic, disturbed sleep patterns, feeding problems, and developmental concerns.

While reducing stress is important for everyone, premature babies appear to be especially vulnerable to the negative effects. This is because premature babies are not only exposed to physical stress from illness, the physical effects of a premature birth, and the intense medical care in the neonatal intensive care unit (NICU), but because their nervous system is immature they’re less able to mount any kind of protective responses.

Fortunately, this mind-body connection can be harnessed to facilitate wellness, even for a baby in the NICU. Positive thoughts, taming the stress response, and working towards emotional wellbeing promotes the best chemical and hormonal responses, which can positively impact your premature baby’s health.

The first thing is to work on your own emotional health, because up to 40% of mothers with a premature baby develop post partum depression and up to 75% develop post-traumatic stress disorder (PTSD). Make sure you are screened for post partum depression and if you are feeling stressed, anxious or are having flashbacks, ask for help from the social worker, your OB/GYN, or therapist if you already have one.

Don’t neglect your physical health. While you may be deconditioned from bed rest and/or the physical recovery from your delivery, try to get outside two or three times a day for fresh air and as you get stronger, think about some short walks or other physical activity. Make sure you do your best to eat right (it’s hard when your baby is in the hospital, but processed foots and skipping meals will make you feel worse) and get enough sleep. It is better be well rested and in control for 5 hours in the neonatal intensive care unit than be exhausted and nonfunctional for ten hours. Remember, taking care of yourself is taking care of your baby.

Try one or two techniques to reduce stress every day, and then gradually add in others as your mood and emotions dictate.

  • Breath from your diaphragm. When we are stressed we breathe with our chest muscles instead of breathing from the diaphragm (also called belly breathing). Takes some time several times a day to practice deep, cleansing belly breaths for a few minutes. Put your hand on your belly and focus on taking deep, natural breaths—if your belly is moving up and down you are doing it right.
  • Practice pausing. When you find your stress level rising, stop what you’re doing and shift your focus away from what you cannot change, such as oxygen levels and infection, and focus on what you can influence, such as positive interactions with your baby or learning more about her condition.
  • Say affirmations, which are positive statements that when repeated help combat negative thoughts and feelings by reprogramming the unconscious mind. Podcasts and CDs are available. Affirmations can be found in books, on preprinted cards, and even services that will text affirmations to your cell phone. Another option is to buy a pack of 3 x 5 note cards and create your own. Some examples include, “I am strong and courageous,” and “I will share my spirit with my baby.”
  • Journal, because some thoughts are too hard to say out loud, but still need to be released. Write everything down on paper.
  • Keep your hands busy. Celebrate your baby with pictures and mementoes in a baby book. Knitting, crocheting, and sewing are also excellent stress relievers.

To maximize positive interaction and minimize stress on the nervous system it is also very important for a preemie parents to learn their baby’s stress cues.

  • Ask if your baby is stable enough for kangaroo care (holding your baby skin to skin). Your rhythms and warmth are soothing and healing (for both of you!).
  • Make eye contact, smile, and interact with your baby if your baby is ready to accept that kind of stimulation (your baby’s nurse will help you learn to read her cures so you can tell when she is physically receptive). Babies absorb every interaction (it actually helps program the nervous system), because of physical challenges many premature babies have fewer opportunities.
  • Offer a pacifier at regular intervals and any time your baby appears stressed. Sucking a pacifier is comforting for a premature baby and helps the developing nervous system form positive connections.

ABOUT THE AUTHOR:

Jennifer Gunter, MD, is an internationally renowned ob/gyn and leading expert in the field of women’s pain medicine.  She lives in Mill Valley, California. To see videos of Dr. Gunter and her preemie sons, Victor and Oliver, in action visit: www.preemieprimer.com.

From the press release for the book:

12.3 percent of babies are born prematurely every year in United States (March of Dimes), while in many northern European countries that rate is 5 percent — representing an alarming statistic as prematurity is the leading cause of death and disability for newborns. Not only that, but neonatal intensive care unit costs alone for premature babies are $6 billion a year, representing 47 percent of costs for all infant hospitalizations and 27 percent of all pediatric stays in hospital (Pediatrics, Oct 2010).

After rounds of fertilization treatments, Dr. Jennifer Gunter, ob/gyn, became pregnant with triplets. Twenty-two and a half weeks into her pregnancy she suddenly went into labor and delivered her first son, Aidan, who died just three minutes later.  Then something unexpectedhappened-she stopped delivering.  Nearly four weeks later, at week twenty-six, Jennifer delivered her sons, Oliver and Victor-weighing one pound eleven ounces and one pound thirteen ounces, respectively-and became a parent of preemies.

Approximately five hundred thousand babies are born prematurely every year in the United States. In fact, prematurity is the leading cause of death and disability for newborns. In The Preemie Primer: A Complete Guide for Parents of Premature Babies-from Birth through the Toddler Years and Beyond, Dr. Gunter provides a comprehensive resource that covers everything from delivery and hospitalization in the NICU to preemie development and parenting multiples-even discussing specific topics like finding a car seat for your preemie, setting special needs preemies up in school, and understanding insurance plans and medical billing.