@#%*!

CNN

CNN reported on a new study that reported that swearing actually has a pain-lessening effect! When someone swears they increase their threshold for pain. Threshold is defined as we can bear it longer and don't feel it as much! See women have known natural pain coping techniques for a long time!
lerance.”

The CNN article even has this quote from the study author: “I swore a bit and then around the same time, our daughter was born. My wife swore throughout her labor…and the midwife said don’t worry about it, we hear that language all the time.” Not surprising, says clinical psychologist Paula Bloom. “From my own experience of giving birth without drugs to a 9 pound, 11 ounce child, I can imagine I had quite the little truck driver vocabulary going on.”

For the study, participants submerged one hand in nearly freezing water for as long as they could while repeating a curse word. Later the participants submerged the same hand again, this time repeating a word they would use to describe a table. When people were cursing, they kept their hand in the water for 40 more seconds than they could otherwise."

So for those of us who do simulations, the ice exercise, etc and encourage them to try affirmations, aromatherapy, massage, distraction, movement.... are you going to have them do a practice contraction and curse away?

Updated Guide to a Healthy Birth available!

The 2009/2010 Guide to a Healthy Birth is now available - what a great resource!

You can read the pdf version Choices in Childbirth but you can also order them as a booklet to hand out in your birth classes. The articles are great and the reference links are wonderful. And the costs are low and (appear to be just for the shipping fees.)

A huge thanks to all who have created this booklet and made it so accessible!

(You might want to keep a couple in your car or bag to randomly give out to pregnant people you see out and about!)

Maternity health care ala' the guinea pig approach!

Cochrane report on GBS

The Cochrane Collaboration examined the evidence around administering intrapartum antibiotics for women who had tested positive for Group B strep. The fact I have a picture of a guinea pig is a hint to yet another intervention becoming pretty routine and then a big "oops, we really don't have the research to back this up but now it's standard of care." Didn't the same thing happen with Electronic Fetal Monitoring?

From the report:

Background

Maternal colonization with group B streptococcus (GBS) during pregnancy increases the risk of neonatal infection by vertical transmission. Administration of intrapartum antibiotic prophylaxis (IAP) during labor has been associated with a reduction in early onset GBS disease (EOGBSD). However, treating all colonized women during labor exposes a large number of women and infants to possible adverse effects without benefit.....
Ideally the effectiveness of IAP to reduce neonatal GBS infections should be studied in adequately sized double-blind controlled trials. The opportunity to conduct such trials has likely been lost, as practice guidelines (albeit without good evidence) have been introduced in many jurisdictions.


Yet another challenge for childbirth educators who are committed to telling the truth and knowing some may not be overjoyed when asked by their patients: "Where's the evidence?" Any suggestions for new childbirth educators from those who have navigated these waters before?

Ask Questions!

Stacie Bingham, an amazing childbirth educator and PfB grad, sent me a link to this great video on the AHRQ website - I absolutely love it! Can we have these streaming as people come into our childbirth class?

More:




AHRQ

Babies sell better than sex?

I thought everyone had seen this ad but I was at a gathering of birth people this weekend and we started talking about You Tube videos and when I mentioned this one, there were blank stares. So decided to start the week with this uplifting clip!

Lobby labor and bed dystocia

There are two terms I would love to see used more often. The first is LOBBY LABOR. Most hospitals are investing huge sums into their lobbies and they meant to be welcoming and peaceful and spacious. Well some laboring women get anxious about getting to the hospital or being stuck in traffic, talk about going to the hospital when they feel the need and then instead of immediately checking in, walk the lobby until those contractions are intense and frequent enough that you feel you need to be where you are going to birth.



The other term is BED DYSTOCIA. You have heard about shoulder dystocia and emotional dystocia, now it's time to talk about bed dystocia - a result of spending too much time horizontal! And do you hear from women at your reunions that they were pretty much on their backs with their head elevated a little bit with their legs up in the "leg rests" ? This is NOT semi-recumbent. I love this book, it's a bit hard to find but CAPERS is always a great place to find the "gems."
The author talks about the need to standardize the definition for semi-recumbent - too many use it to describe anything that's not completely flat on her back. In actuality, the minimum should be a 45 degree angle between the bed and her spin, anything less is supine, on her back!

So do whatever you can do to keep women out of this position!

Placenta preparation

So if someone in your next childbirth class asks you to share everything you know about placenta encapsulation, would you hmmm and haw or would you be able to go into an in-depth explanation of the process?
I enjoyed reading this Time article (it uses humor!) and watching the companion clip of the Placenta Lady preparing the capsules!

Placenta encapsulation

Real Risks of Cesarean

Lamaze president Pam Spry has a great interview on Medscape. To view it, you have to have an account which is free and quick - so sign up! The Real Risks of Cesareans

While you are there, read about the new induction guidelines revised by ACOG

Happy Birthday, Passion for Birth!

Seven years ago Passion for Birth held it's first seminar! I just wanted to pause and thank the "Passioneers" (the incredible learning facilitators who have led those workshops: about us ); the hosts who have provided the space and the footwork to have the seminars, and to all of the 1200+ people who have come and are now "stomping out boring childbirth classes."

Thank you! Now it's time to celebrate - throw the confetti and eat some of the virtual cake and ice cream.

Want to blog?

The application is open!

Like to write? PfB is looking for someone who is beginning on the path to become a Lamaze childbirth educator to join us and to blog frequently about your feelings/experiences/aha moments/ challenges and more. And in exchange you will get a complimentary Passion for Birth seminar registration!

Interested? If chosen, you are committing to blogging at least once a week - all the way until you pass your Lamaze certification exam (or we agree on another time frame) The purpose of the blog will be to share your journey with others so that they can see what it's really like.

Interested? Do you have solid access to a computer and the internet? If yes, in an email, write a sample paragraph that we could post (if you are chosen) on the blog about you and your background. (keep it light and short!)

Send a writing sample and choose one or two of these: (just 2 -3 paragraphs each)
why do you want to be a cbe or
talk about a significant birth in your life or
a teaching tip

Also - Describe what might stop you from being able to blog once a week. What are the barriers you see to becoming a childbirth educator?
Are you on facebook? Twitter?

We are looking for someone with the passion to be a dynamic educator, you don't need an extensive back ground to begin!

If selected, what do you get? We will waive your registration fee for a seminar. You will need to cover your travel etc. You will also need to pay for your study guide and your certification exam fees. And if there is not a seminar close to you, let me know if you would be interested in setting up one near you.

Deadline? August 1! Send to teri@passionforbirth.com

Teen pregnancy and Atlanta doula program

Every community needs programs like this!

The Doula Story from Stuart Productions on Vimeo.

Doodle!

NPR story on Doodling

In February, Applied Cognitive Psychology of Wiley InterScience published Jackie Andrade's findings about doodling. I think it's time to hand out pads for doodling in CB class!

She looked at the impact of doodling on concentration and memory. The participants had to listen to a boring telephone message with names of people as well as some irrelevant information. The doodling group was given paper with shapes -- alternating rows of squares and circles -- and the control group was given lined paper. The doodlers doodled, the control group didn't. In the end, the doodlers were found to have 29% better recall of the names than the non-doodlers.

Although most training could not be equated to a "boring telephone message," think how much more effective learner retention would be if doodlers were not inhibited from doing what comes naturally.

Doodle on a pad While I was researching "doodling" for this post, I came upon this site and actually made the doodle above. So now if you are stuck on a boring conference call, you can doodle away on your laptop!

Lamaze on the Lawn

You never know where you will find a Passion for Birth alumni! Jada Shapiro is providing "Lamaze on Lawn" at a Brooklyn baseball game! Way to go Jada!! The day is focused on Pregnancy with these events:

* Barefoot & Pregnant: Expectant moms can run (or, more likely, walk) the bases with no shoes on before the game
* Craving Station: A table on the Concourse level will offer pickles, ice cream, anchovy pizza, etc. for pregnant women who crave more than the usual ballpark fare
* Water Break: Two expectant fathers will try to complete a race with water balloons attached to their bodies. The winner is the one who lasts the longest or finishes the race without his water breaking
* 7th Inning Stretch Marks: Pregnant women will be allowed onto the field in the 7th inning to sing Take Me Out to the Ballgame
* Lamaze on the Lawn: The Cyclones will offer a Pre-game Lamaze class on the grass in centerfield taught by Birth Day Presence
* Special Delivery: Any woman who gives birth at the ballpark before the end of the game gets free Cyclones Season Tickets for life for each member of her new family
* Naming Rights: Any expectant mother who agrees to name her child “Brooklyn” or “Cy” gets free Season Tickets for life
* Pregnancy Pitch: Any woman in her third trimester gets to throw out a ceremonial first pitch before the game
* Trimester Tricycles: Bike race between expectant fathers between innings


Brooklyn Cyclones

Now someone had fun with a theme! I hope Jada will share some pictures of the class in centerfield!

And what are you doing this summer to get your childbirth classes out there in unusual places?

A top-notch resource

Click immediately to this site and soak up the great resource that Andrea Lythgoe has pulled together - thank you!

Understanding Research - the Birth Professionals Guide to Reading Research

She has done a great job of taking something that is usually overwhelming and made it logical, accessible and simple. She has provided written guidance in such a way that it's a lot like having someone very wise sitting on your shoulder, providing gentle support and occasionally whispering "try this" or "look here" in your ear. Before you leave the site, leave her a comment and thank her!

So as a childbirth educator how do you keep up on the research? How many hours a week is reasonable for you to spend? Are you a research junkie and look out for new studies like a blood hound or do you want somebody to spoon feed you? (I have been at both ends of the spectrum!)

Gave me a chuckle

see more Fail Blog

Have you found that a lot of people come to childbirth class and want to learn how to breathe? The clipping from "Fail Blog" made we chuckle.

Maybe childbirth educators could grab a headline:
"Childbirth educators agree that breathing during labor and birth are good for mom and the baby (and the partner and the care givers..)"

Joking aside, I think childbirth educators need to make sure people in their programs leave feeling confident that they know how to breathe! While most programs have gotten away from teaching prescribed breathing patterns, it is still important to talk about the value in slow paced breathing. It's important to talk about the importance of rhythm, no matter what pattern they choose. We should highlight that often breathing becomes part of the ritual for coping with contractions. I also talk about how our bodies do a good job of bringing air in, but sometimes we don't completely exhale. So I do talk about focusing on the exhale or sighing out for a tension release.

What do you teach in regards to breathing?

Garr slides

I know I tend to go on and on about how presenters need to step up and stop making PowerPoint presentations that are actually handouts on slides. I have been inspired by Presentation Zen and here are some great examples of wonderful ways to be more effective. It's not a presentation but a collection - even with no narration I know you will get the point!

Sample slides by Garr Reynolds

View more Microsoft Word documents from garr.

It's also worth checking out his Mkrus Blog Post for more inspiration. And another wise post by Bobgable

Listen...

Thought you might like to listen to a discussion about the role of pain!



And let's talk about the role of podcasts and the childbirth educator... do you have a podcast on your website - what would be a great topic? - if people could hear your voice, might they be more likely to sign up for your classes?

End of attention span

This ad illustrates a point that I make in seminars. When people are at the end of their attention span, they can go off on mental tangents similar to the one this guy does! It's so important that we as learning facilitators, do our best to honor short attention spans and bring them back!

The example I use in seminars comes from Michelle Deck. "Imagine you are going over the risks/benefits of Cesarean birth. Some one at the end of their attention span hears Cesarean and drifts off to ponder if the name comes from Cesar and then wonders if Cesar salad is named after him. And then recalls the last time they had a Cesar salad and how they were having lunch with Joe. And how Joe is getting a divorce and may be selling their house. And how they are having a baby and need a bigger house, and should call Joe. Meanwhile you as their childbirth educator have gone on and on about Cesarean birth and they are buying real estate!"

So make a commitment to not go on and on and allow every one to reach the end of their attention span... trust me, it happens less if you involve people to be active in their learning.

Next time you are in a lecture as a listener, time yourself. How long until you drift off and think of something unrelated to the speaker? What brings you back?

What to expect to go wrong

Yesterday I blogged about the importance of reaching women before the pee dries on their pregnancy test, when they are making those important decisions about where and with whom they will birth...well, I am not convinced this book will be promoting choosing providers and places with low interventions. And the sister book that has been around forever about "what to expect to go WRONG during pregnancy", has never been my favorite. I use to ask my childbirth classes who has read it...now I ask how many copies people have. It amazes me how it continues to outsell books that have a healthier message. If I could add a sound effect here, it would be a big exasperated sigh!

TIME review: What to Expect Before You are Expecting

by Bonnie rochman

An Excerpt:
"You're either a fan of these sorts of let-me-give-you-the-worst-case-scenario books or you're not. While there's no doubt Murkoff's tomes are brimming with well-researched information, they're also packed with implausible situations that serve only to ramp up maternal anxiety. To wit: super-frequent flyers could risk excessive radiation exposure from the sun at high altitudes, so if you're pregnant, Murkoff says you might consider revamping your itinerary in favor of shorter flights at lower altitudes.

"A book like this is organized around anxiety," says Maggie Little, a bioethicist at Georgetown University and a member of the Ob-Gyn Risk Research Group, which includes experts from obstetrics and gynecology as well as bioethics, philosophy, medical epidemiology and sociology, who mull over risk — both real and perceived — in women's reproductive lives. "It would take a normal person and make her crazy."

Look at the stats!

Wouldn't it be nice if all obstetrical practices were so transparent? I have to admit that my first reaction was questioning if this was real or not. I have put a few feelers out and it seems to be.


Minimally invasive obstetrics

So what would your childbirth classes "look" like if you taught for them....I wonder who does teach their classes. Anyone who reads this?

Previously I ran a poll asking what has the biggest impact on a woman's birth? The clear majority said "her labor support team." More and more these days I am leaning towards her choice of care provider and where she births.

Let me explain: If you wanted a new luxury vehicle, what are you chances if you only shop at "Buy-A-Wreck?" If you wanted a pampered retreat and signed up for a wilderness outdoor challenge course, what are your chances of a successful experience? If you have chosen to go to a care provider who works at a facility that does 95% epidurals, 50% inductions, 40% cesareans .... what are the chances - no matter how confident the laboring mother is and how wonderful her support team is?

Ah the challenges we face as childbirth educators. We have to find a way to influence those early decisions - before the pee dries on the "you are pregnant stick!"

Movement

I have volunteered over the years to be part of the volunteer committee that originally created and now reviews and updates the Lamaze Care Practices that support normal birth. The name has been tweaked to Healthy Birth Practices to change their focus more to pregnant women. There are six and my "baby" is the one about being active in labor. So originally it was titled "Freedom of Movement." Now it is: "Walk, move around and change positions throughout labor."

So when I saw this You Tube movie from Equador, I loved it. (Even though my Spanish is limited to greetings and a lot of head nodding and sign language!)



So here is today's challenge....add up the minutes you teach in a series or a one day workshop. Then add up how much of the time is spent out of their chairs and NOT in horizontal positions on the floor. (not fair to count the breaks) What should the ratio be if you really want to model what you preach to be active and move! And grab the stopwatch and also time those birth videos you show - what percentage are they filmed in bed and what percentage are they out and moving around? What should be the minimum ratio before you will show them in your program?

Great clips re: the Healthy Birth Practices!

How exciting is this! Watch these clips that support the Healthy Birth Practices we have been promoting! Thanks Lamaze!

Japanese historical dolls

I found the pictures at pregnant-dolls-from-edo-period-japan very interesting - these are from the 19th century! (Don't know if you want to explore around this site too much as the ads are...well... the next page is titled Marriage Hunting Bra and previous page is Fact of Life Boom Boom remix!)

But I found the fact that these dolls were used for training midwives and also featured in educational sessions for the public that were held at carnivals to evoke a sense of wonder about a variety of topics. Now that's one venue I have NOT thought about having a childbirth class!

Let's talk about venues for classes - I have taught in a physical therapy room which had lots of options for seating! I've heard about classes being held in Bed and Breakfasts, factory lunch rooms, clinic waiting rooms - where is the most unique area you have heard about?

Breech birth and baby butts and scientific drawings!

Is there anything cuter than a baby's butt? I started to write this blog today about the new Breech Birth study that is being launched. I started to look for pictures of breech babies and all I could see were those cross sectional medical pictures that sparked an old memory of a dad in a childbirth class a long time ago. He was quite vocal about how he didn't like those cross sectional headless legless pregnant lady posters - he didn't want to see his wife as cut in half and a collection of bladder, bones, lungs, intestines. Point well made! He wanted to see her as a whole, beautiful body.

So I went to my source of most of the pictures I use on this blog and in my presentations istock photo and couldn't find a picture of a pregnant woman that would be the perfect picture... but then spotted this cute baby butt and decided we are talking about butt first or foot first and felt this fit the bill! (or at least would get or hold your attention as you "awwwww" and "ahhhh")

But back to the Breech study - Passion for Birth graduate Beth Day has done a great job describing it on her blog - so I am going to send you there

Shape of a Mother

At Passion for Birth, we have started a mantra for us as Childbirth Educators. "Build Confidence. Have Fun. Be Bold." As I was looking at blogs, I wanted to commend the creator of The Shape of a Mother She is bold and is making big steps to help women accept the strength of their bodies and accept what they look like after we have birthed our babies. Make sure the people in your class understand the images they often see of post partum mothers are often airbrushed and not a true depiction.

She writes about the motivation behind creating her website:

One day I sat in a restaurant in Anaheim, California eating breakfast, when a woman passed by my table with her infant carrier in tow. As she lifted it up to fit between the tables, her shirt raised and I saw that, although she was at a healthy weight and her body was fit, she had that same extra skin hanging around her belly that I do. It occurred to me that a post-pregnancy body is one of this society's greatest secrets; all we see of the female body is that which is airbrushed and perfect, and if we look any different, we hide it from the light of day in fear of being seen. That makes me want to cry. Sure we all talk about the sagging boobs and other parts, but no one ever sees them. Or if they do, it's in comical form, mocking the beauty that created and nourished our children.

It is my dream, then, to create this website where women of all ages, shapes, sizes and nationalities can share images of their bodies so it will no longer be secret. So we can finally see what women really look like sans airbrushes and plastic surgery. I think it would be nothing short of amazing if a few of our hearts are healed, or if we begin to cherish our new bodies which have done so much for the human race. What if the next generation grows up knowing how normal our bodies are? How truly awesome would that be?

Common things about fear...

I was reading an article in magazine Inc. that made me think about the universality of fear.

The author writes:
"Fear can be a motivator but it can also lead you into bad decisions......They've done it because they've been afraid, and fear makes us shortsighted." (They were addressing decisions in a recession but the same is true about birth, isn't it?)

So when childbirth education programs talk about giving people all the current information/evidence and giving them the freedom of choice, I think we have to go a step further. Is there really freedom of choice when the decision is being made out of fear? So maybe we need to focus on removing the fear around birth and supporting people to make the best decisions without the influence of fear?

Birth in the Second Life

Last year I blogged about setting up trainings in the Second Life and thought I was being pretty forward thinking. And then I toyed with the idea of teaching childbirth classes in the Second Life... but Amy Romano highlighted this project in a Facebook post where they have designed a virtual birth center in Second Life for training midwives on key issues of environment and impact of environment on normal birth.

The audio is less than best but worth watching.






Now let's think about using the Second Life tool as childbirth educators... where is the potential? Maybe we could start out and simply design the ideal space for teaching childbirth education programs. So many of us are stuck in places that have been adapted but not designed for learning facilitation! Share what you would fantasize about in your CB space. Me? Selfishly I would love audio/visual equipment that would work with no stress on my part - screens that can fade away without be a distraction and a portable device (palm size) that I could use from anywhere in the room to orchestrate the sharing of DVDs, music, etc, etc.

Quote from Your Best Birth, the book

"You can't have a child without going on a journey, whatever that journey will be," she said. "A woman has to get to know her body, get to know her baby, start to understand her fears, and experience how her hormones change and how what she learns from the people she speaks with along the way affect her ideas about the birth. What she decides at week ten might be the opposite of what she's confident of at week thirty-five. This is a process that puts the woman at the center, and we go on the journey with her. But we don't lead. She does."

Jennifer Walker
Your Best Birth

Wouldn't this be a great quote to have in an early pregnancy class?

4th of July!

I have been trying to have a blog post daily for a few months. There is certainly enough to think about in the dynamic world of childbirth education to have something to comment on or ponder or to question! But as I was looking at writing something for the 4th of July, I paused and decided to share a little personal insight into my pathway to become a childbirth educator.



In 1986, my husband and I had just returned from working for 4 years with the Peace Corps in Lesotho (southern Africa), and he had gotten a position with the National Park Service in Yorktown, VA. We moved into the smallest place we have ever lived - the summer kitchen/slave quarters of the Moore House. (So small that when you opened the refrigerator door on one wall and a drawer on the opposite, they hit. What the picture above doesn't show is that the small quarters also housed the entire heating/cooling system of the main house)

So how does this relate to the 4th of July? The Moore house is where the terms of the surrender of the War of Independence were signed by Washington and Cornwallis (actually he didn't show, and sent an underling)

How does this relate to my childbirth education pathway? Well we lived here when I took my first childbirth class and midway through the series, it hit me. "I want to do what this childbirth educator does." After the birth of my son, I took my educator out to lunch and asked her what I needed to do. And she was certified by Lamaze and the rest is history! Thanks Sharon.

For those of you in the US, I hope your fourth of July includes laughter, fun, fresh air, and family time! For others, I hope the same for you on your national day of independence!

Men and pain - oh my.

So, would you use a part of this clip in a childbirth class? Make it an assignment to watch on You Tube? Or?

As you watch this you may wonder about the hitting of the stress balls. You can learn more about it on Juju's website. I first became aware of it when I read her book. It's worth a read as there are a couple other creative ideas.

Hey - come to Australia with me!

Been dreaming of traveling down under? Well join me in Australia in October! Do a seminar and then explore the country! For more information go to CAPERS.
There is a regular 3 day seminar and then a handful of one day workshops. And on the way home, I am stopping in New Zealand ...hope I see you there!

Winners are announced!

CHECK OUT WHO WON! Congratulations! And special thanks to Birth Matters Virginia for the creativity you inspired by having this contest. The entries were so wonderful and touching!

I hope some of the creators make their videos available for childbirth educators to use in their classes. We need these images!