Now that I'm certified, I have put more time and effort into getting my course into tip-top shape than I ever imagined. I spend countless hours finding resources, printing handouts, outlining, gathering materials and organizing. It seems as though each time I teach, I discover that there's just one more thing I need to make class go a little smoother. I don't dread any of it. I am still enjoying every bit of work I'm doing.
I seem to have attracted women who are late in their pregnancies. It causes some stress on my end, making sure I cover enough material to get them to the birth of their babies. I recently had a mom deliver two weeks into our six week class. I felt terrible. I felt as though I hadn't gotten to the real meat of Lamaze. I was relieved to visit her and find that she did remarkably well in her labor and birth and it seemed as though most of the information we were able to cover in our short time together, she retained and used! It was certainly an eye-opener and has directed me back to my curriculum to make a few adjustments. It also seems to have given the the opportunity to do some hands-on baby care classes, which I'm sure will be much more helpful than swaddling and diapering a doll!
Since beginning this (what I believe to be) very important work, I have been taken aback by how honored I feel to be allowed into people's homes and educate them on their pregnancy and birth. If I get too caught up in it, it's easy to feel overwhelmed by the responsibility, but I am trying to focus on giving each family the best education possible. Teaching privately has allowed me to be much more personal with my students. I have the opportunity to learn about their journeys through life and pregnancy. I am fascinated by the courage that many women have. Already, they have taught me so much professionally and personally. I am continually amazed at the strength that families, and women in particular, have. So many have struggled to get pregnant, experienced loss, have health concerns or even have partners who are unable to attend the birth of their babies. These women have handled each situation with poise and grace. I am inspired by and admire their strength and positive attitudes. My journey through Lamaze has only just begun.
Tuesday, July 20, 2010
Thursday, June 3, 2010
Certification
I just checked lamaze.org and the exam results are posted. I am thrilled that I passed and can really begin the next part of my journey!
Friday, May 28, 2010
Healthy Birth Practices
This evening, I found myself in the gym flipping through the stations on the TV attached to the elliptical. I had doubt that I would find much on at eight o'clock on a Friday night. I happened upon MTV's 16 and Pregnant. This is a show I have watched bits and pieces of in the past, but have never been able to watch a full episode. I don't care for the program for a number of reasons, but found myself getting very involved tonight. A year ago, I would not have been thinking about Lamaze's Healthy Birth Practices while watching this show, but that is exactly what I was doing tonight.
The staff was good about asking the mom about who she planned to have with her for support (care practice #3) and when her over-bearing mother tried to avoid certain questions, the nurse offered to answer questions in private with the pregnant teen. However, I cringed when the nurse pointed out that "all of the equipment that we need for delivery is in the room." (Care practice #4)(The episode is here and the hospital tour is at about 15:30) I couldn't help but think of how many babies were born before there was any equipment. While it is used for some very good reasons in some births and some women take comfort in the information it provides, I can't shake the notion that women's bodies are designed to birth babies. The equipment doesn't change that fact.
Some time after receiving an epidural, it was time to push. It wasn't surprising to see directed pushing being used, but there was one moment that stood out. The nurse wanted Mom to start pushing and Mom was waiting until she could focus inwardly before beginning. I was proud of her for taking control of the situation and pushing when and how she needed to (care practice 5).
Finally, a beautiful baby girl emerged. The doctor held her up for Mom to see, had the grandmother cut the cord and took the baby to the warmer. Due to the magic of television, it is unclear how much time the baby was there but when the hospital staff was done, they brought a completely bundled baby to see her mom for the first time. I immediately thought "Number 6! No separation of Mom and Baby with unlimited opportunity to breastfeed." (Healthy Birth Practice #6) A year ago, that thought never would have crossed my mind.
I recently posted on childbirth as it is portrayed in programming for preschoolers. Watching this show led me to consider similar questions about childbirth in programs for teens. I wonder if there are any episodes showing young moms who chose unmediated births or even home births. If not, what impact would including different types of birth have on teens?
As always, I want to emphasize that each woman should choose how she handles the birth of her child. My goal is to make sure that families have evidence-based information to make their own decisions. Much of the information I have learned in the past 10 months would have changed the questions I asked and the ways in which I chose to advocate for myself during the birth of my own children.
The staff was good about asking the mom about who she planned to have with her for support (care practice #3) and when her over-bearing mother tried to avoid certain questions, the nurse offered to answer questions in private with the pregnant teen. However, I cringed when the nurse pointed out that "all of the equipment that we need for delivery is in the room." (Care practice #4)(The episode is here and the hospital tour is at about 15:30) I couldn't help but think of how many babies were born before there was any equipment. While it is used for some very good reasons in some births and some women take comfort in the information it provides, I can't shake the notion that women's bodies are designed to birth babies. The equipment doesn't change that fact.
Some time after receiving an epidural, it was time to push. It wasn't surprising to see directed pushing being used, but there was one moment that stood out. The nurse wanted Mom to start pushing and Mom was waiting until she could focus inwardly before beginning. I was proud of her for taking control of the situation and pushing when and how she needed to (care practice 5).
Finally, a beautiful baby girl emerged. The doctor held her up for Mom to see, had the grandmother cut the cord and took the baby to the warmer. Due to the magic of television, it is unclear how much time the baby was there but when the hospital staff was done, they brought a completely bundled baby to see her mom for the first time. I immediately thought "Number 6! No separation of Mom and Baby with unlimited opportunity to breastfeed." (Healthy Birth Practice #6) A year ago, that thought never would have crossed my mind.
I recently posted on childbirth as it is portrayed in programming for preschoolers. Watching this show led me to consider similar questions about childbirth in programs for teens. I wonder if there are any episodes showing young moms who chose unmediated births or even home births. If not, what impact would including different types of birth have on teens?
As always, I want to emphasize that each woman should choose how she handles the birth of her child. My goal is to make sure that families have evidence-based information to make their own decisions. Much of the information I have learned in the past 10 months would have changed the questions I asked and the ways in which I chose to advocate for myself during the birth of my own children.
Tuesday, May 18, 2010
Postpatrum Depression
The Department of Health and Human Services says that "about 13% of pregnant women and new mothers have depression." The American Congress of Obstetricians and Gynecologist states that 70 - 80% of women experience the "baby blues." More recent studies seem to be indicating that Postpartum Depression is even more prevalent. There is no doubt that postpartum depression is a concern for pregnant and new moms, but what may surprise some people is that dads can suffer from depression after the arrival of a new baby as well.
CNN posted this article about postpartum depression in men. It is clear from the article that more research is needed. What causes this depression? Does the medicalization of birth play a factor? Are we educating and/or preparing men as well as we should be for the arrival of their babies? How can we incorporate adequate screening for depression for a couple into prenatal and postpartum care? As childbirth educators, how can we address this in our classes and what should we be looking for? These are questions I don't have the answers to, but would be interested in seeing the research surrounding the subject.
You can read a Lamaze article on Postpartum Depression and Baby Blues here.
CNN posted this article about postpartum depression in men. It is clear from the article that more research is needed. What causes this depression? Does the medicalization of birth play a factor? Are we educating and/or preparing men as well as we should be for the arrival of their babies? How can we incorporate adequate screening for depression for a couple into prenatal and postpartum care? As childbirth educators, how can we address this in our classes and what should we be looking for? These are questions I don't have the answers to, but would be interested in seeing the research surrounding the subject.
You can read a Lamaze article on Postpartum Depression and Baby Blues here.
Wednesday, May 5, 2010
Children's Programming
It has been a while since my last post. The exam is done and after a fantastic opportunity to meet with Lamaze's Certification Council, I have returned to blogging.
I have begun reading Jennifer Block's Pushed once again. I started this book a few months ago, but chose to read some other things to prepare for certification. I recommend that anyone wishing to have a safe and healthy birth read it before even getting pregnant. It includes great, evidence-based information that everyone should know before making their birthing decisions. With this reading comes an increased awareness of birth in the word around me.
In the past two days, I have watched two separate children's cartoons in which a mom is having a second baby. A year ago, I never would have thought twice about the way the birthing process is portrayed, but since beginning my journey through Lamaze, things have changed.
We are always seeing birth portrayed in the media and too often it is presented with very little variation. Women see other women laboring in a hospital bed connected to IVs, monitors and with epidurals. While this is the reality for many women, it is not what all women want. I believe there should be a variety of birthing experiences presented in the media and it may aid women in advocating for the types of births they wish to achieve.
While viewing these cartoons with my son, it occurred to me that we are perpetuating the cycle with our children. In both cases, the parents went to the hospital to have a baby. In one case, the mom was having contractions that were somewhat unrealistic. I'm not suggesting we need to be too graphic or detailed, but smiles and "ohs" are also not what children may see while their moms are in labor. We may be setting our children up to be frightened when what they see is so different from what they imagined. In the second program, the new big sister went to visit her new baby brother in the "baby hospital." They passed two nurseries filled with babies before getting to the third nursery where the new baby slept with six others.
I understand that cartoons are not aimed at an adult audience, but perhaps by varying birthing locations (i.e. hospital, home birth, birthing center) and portraying more "ideal" situations, such as visiting baby who is cuddled up with Mom we can help to guide a generation of children to know that there are a variety of birthing options and choices that can be made. By presenting the safe and healthy arrival of a new family member in a variety of ways we may help our children have different expectations for a birthing experience and perhaps be good advocates for themselves when the time comes.
I know that there are a few concerns with this. First off, I could eliminate the television viewing and solve the problem. I'm expecting a lot from a children's cartoon. The reality is, my kids watch TV and I want what they are viewing to expose them to many different things presented in many different ways. This is true not just of birthing experiences, but of all information presented in children's programming. What do you think?
I have begun reading Jennifer Block's Pushed once again. I started this book a few months ago, but chose to read some other things to prepare for certification. I recommend that anyone wishing to have a safe and healthy birth read it before even getting pregnant. It includes great, evidence-based information that everyone should know before making their birthing decisions. With this reading comes an increased awareness of birth in the word around me.
In the past two days, I have watched two separate children's cartoons in which a mom is having a second baby. A year ago, I never would have thought twice about the way the birthing process is portrayed, but since beginning my journey through Lamaze, things have changed.
We are always seeing birth portrayed in the media and too often it is presented with very little variation. Women see other women laboring in a hospital bed connected to IVs, monitors and with epidurals. While this is the reality for many women, it is not what all women want. I believe there should be a variety of birthing experiences presented in the media and it may aid women in advocating for the types of births they wish to achieve.
While viewing these cartoons with my son, it occurred to me that we are perpetuating the cycle with our children. In both cases, the parents went to the hospital to have a baby. In one case, the mom was having contractions that were somewhat unrealistic. I'm not suggesting we need to be too graphic or detailed, but smiles and "ohs" are also not what children may see while their moms are in labor. We may be setting our children up to be frightened when what they see is so different from what they imagined. In the second program, the new big sister went to visit her new baby brother in the "baby hospital." They passed two nurseries filled with babies before getting to the third nursery where the new baby slept with six others.
I understand that cartoons are not aimed at an adult audience, but perhaps by varying birthing locations (i.e. hospital, home birth, birthing center) and portraying more "ideal" situations, such as visiting baby who is cuddled up with Mom we can help to guide a generation of children to know that there are a variety of birthing options and choices that can be made. By presenting the safe and healthy arrival of a new family member in a variety of ways we may help our children have different expectations for a birthing experience and perhaps be good advocates for themselves when the time comes.
I know that there are a few concerns with this. First off, I could eliminate the television viewing and solve the problem. I'm expecting a lot from a children's cartoon. The reality is, my kids watch TV and I want what they are viewing to expose them to many different things presented in many different ways. This is true not just of birthing experiences, but of all information presented in children's programming. What do you think?
Friday, February 5, 2010
Amazing
I have been struggling a little bit to get my birth observations done. I understand that this is a very personal and private event and am not surprised that this has proved to be a challenge. After offering support to the families in the childbirth class I observed and having no takers, I contacted a small hospital which uses the midwifery model of care. It also happens to have some of the nicest employees around. I had been in contact with a nurse/childbirth educator who put me in contact with her nurse manager. After getting cleared with volunteer services, I was set to observe.
The phone rang at about 7:30 the morning after I was medically cleared to observe. The nurse manager said she had a mom who was willing to let me observe. She was 3 cm dilated and having her third baby. I thought this had the potential to move quickly, so I hopped in the car and headed north. I arrived a little bit after 8, changed into scrubs and met up with L, the nurse I would be shadowing. She led me into the room, introduced me to the mom and dad and gave me a chair. I would sit in that chair until about 1:35.
The family was pleasant and easy to get along with. I should note that this experience was at times awkward. I was unsure as to when/if to leave the room, speak, look away, etc. Thankfully, the pace of the nurses and the family were easy to follow. Mom's water had broken the night before. She came to the hospital having contractions that weren't really helping her to make any progress. At the time that I arrived, Mom had been in the jacuzzi and was back in bed having an IV started in anticipation of her epidural. Mom had been 3cm dilated for at least a week before her water broke and after several hours of contractions, that's where she stayed. Mom was using a relatively slow paced breathing and doing a great job staying on top of her contractions. She changed positions when she felt the need, used the bathroom, and was monitored intermittently until she received her epidural at about 10:30AM. L was doing a great job of providing support as well as nursing care.
Mom wanted to have a natural birth, but hadn't slept and wasn't making progress. She opted for the epidural to get the rest she needed for the hard work ahead. Not long after feeling relief, Mom was snoring away. Dad also got a much needed breather, using the time to take a walk and have some breakfast. While Mom was resting, her blood pressure dropped and contractions spread out a great deal. There were also some fluctuations with the baby's heart rate that the nurses were keeping an eye on.
During this time, I couldn't help but think that this would end in a section. Then I remembered where I was and the track record of this facility. The nurses had Mom change positions which would resolve the issues for a few minutes. The gave her a whole bunch of fluid as well. The baby was VERY active making it difficult to monitor effectively. After a good stretch of time with low blood pressure, the midwife made the decision to wake Mom up and start pitocin to augment her labor. Dad was clearly very uneasy about all that was going on, asking lots of questions. The nurses were great at putting him at ease and explaining that the best way to assess what was going on was with their hands, not the machines. After pitocin was started, Mom's blood pressure was good, the baby looked great and contractions began coming more regularly. I would estimate that this all happened at about 12:30.
Mom continued to change positions, even with the epidural. She had good relief from the epidural until a little bit before 1. She said she could feel pain on her lower right hip which she guessed was her cervix. The nurses believe that she had a patchy epidural, leaving her an area where she could still feel everything. I vividly remember Mom having a contraction which she had to breath through and make a bit of noise. It caught my attention because it was different from the past few hours with the epidural. I checked the clock. It was 1:07PM. I watched the clock and Mom's contractions were coming less than 3 minutes apart and they were good ones! Mom got more and more uncomfortable and the nurse began to ask if she had the urge to push. Mom did not, but the nurses later said they thought they could feel her making small, involuntary pushes. The decision was made to call anesthesia to see if they could get Mom some relief. In the meantime, the midwife was called in to check Mom's progress. The midwife said she had a small lip and should try to push. This was after 1:35PM. Mom was surprised, as she still didn't have the urge to push. She gave a push while semi-reclined and sort of on her right side. She decided what position to be in and wasn't afraid to tell anyone when she wasn't comfortable. The midwife announced that she moved the head quite a bit and the nurses should get everything ready.
At this time, I attempted to move myself as far out of the way as possible. I really wanted to get a good look at what was about to happen, but also didn't want to interfere with anything. Mom proceeded to "scream the baby out." She pushed, without direction, for what I think was three contractions. She had moments of "I can't do it," "I don't want to," and "GET HIM OUT!" I couldn't believe when I suddenly saw an adorable little face. His body quickly followed. Baby went right to Mom, making very little noise, but doing ok. Mom pushed for less than 6 minutes and once the baby was born, she was like a different person. The pain ended abruptly. She of course had new pain, but it didn't seem so bad. It was probably an hour before the baby boy was taken from Mom. All assessments were done in her arms. I was amazed at how quickly this little boy was interested in nursing. He was giving very clear cues within minutes of his birth. He nursed as soon as he was ready.
I stayed with the family long enough to see how much the baby weighed and decided it was best to let the family enjoy this time. This is the first baby I have ever seen born and I will never forget it. Although there was a time during Mom's yelling when I was glad I had never done it, the overall feeling I had was that it just made sense. What I watched was the way nature intended it to happen. It was amazing. I am forever grateful to this family for allowing me to be a part of the birth of their baby. I am honored to have been a witness to his birth and will never forget this experience. What a great job these nurses have to witness such an amazing event so often in their lives.
The phone rang at about 7:30 the morning after I was medically cleared to observe. The nurse manager said she had a mom who was willing to let me observe. She was 3 cm dilated and having her third baby. I thought this had the potential to move quickly, so I hopped in the car and headed north. I arrived a little bit after 8, changed into scrubs and met up with L, the nurse I would be shadowing. She led me into the room, introduced me to the mom and dad and gave me a chair. I would sit in that chair until about 1:35.
The family was pleasant and easy to get along with. I should note that this experience was at times awkward. I was unsure as to when/if to leave the room, speak, look away, etc. Thankfully, the pace of the nurses and the family were easy to follow. Mom's water had broken the night before. She came to the hospital having contractions that weren't really helping her to make any progress. At the time that I arrived, Mom had been in the jacuzzi and was back in bed having an IV started in anticipation of her epidural. Mom had been 3cm dilated for at least a week before her water broke and after several hours of contractions, that's where she stayed. Mom was using a relatively slow paced breathing and doing a great job staying on top of her contractions. She changed positions when she felt the need, used the bathroom, and was monitored intermittently until she received her epidural at about 10:30AM. L was doing a great job of providing support as well as nursing care.
Mom wanted to have a natural birth, but hadn't slept and wasn't making progress. She opted for the epidural to get the rest she needed for the hard work ahead. Not long after feeling relief, Mom was snoring away. Dad also got a much needed breather, using the time to take a walk and have some breakfast. While Mom was resting, her blood pressure dropped and contractions spread out a great deal. There were also some fluctuations with the baby's heart rate that the nurses were keeping an eye on.
During this time, I couldn't help but think that this would end in a section. Then I remembered where I was and the track record of this facility. The nurses had Mom change positions which would resolve the issues for a few minutes. The gave her a whole bunch of fluid as well. The baby was VERY active making it difficult to monitor effectively. After a good stretch of time with low blood pressure, the midwife made the decision to wake Mom up and start pitocin to augment her labor. Dad was clearly very uneasy about all that was going on, asking lots of questions. The nurses were great at putting him at ease and explaining that the best way to assess what was going on was with their hands, not the machines. After pitocin was started, Mom's blood pressure was good, the baby looked great and contractions began coming more regularly. I would estimate that this all happened at about 12:30.
Mom continued to change positions, even with the epidural. She had good relief from the epidural until a little bit before 1. She said she could feel pain on her lower right hip which she guessed was her cervix. The nurses believe that she had a patchy epidural, leaving her an area where she could still feel everything. I vividly remember Mom having a contraction which she had to breath through and make a bit of noise. It caught my attention because it was different from the past few hours with the epidural. I checked the clock. It was 1:07PM. I watched the clock and Mom's contractions were coming less than 3 minutes apart and they were good ones! Mom got more and more uncomfortable and the nurse began to ask if she had the urge to push. Mom did not, but the nurses later said they thought they could feel her making small, involuntary pushes. The decision was made to call anesthesia to see if they could get Mom some relief. In the meantime, the midwife was called in to check Mom's progress. The midwife said she had a small lip and should try to push. This was after 1:35PM. Mom was surprised, as she still didn't have the urge to push. She gave a push while semi-reclined and sort of on her right side. She decided what position to be in and wasn't afraid to tell anyone when she wasn't comfortable. The midwife announced that she moved the head quite a bit and the nurses should get everything ready.
At this time, I attempted to move myself as far out of the way as possible. I really wanted to get a good look at what was about to happen, but also didn't want to interfere with anything. Mom proceeded to "scream the baby out." She pushed, without direction, for what I think was three contractions. She had moments of "I can't do it," "I don't want to," and "GET HIM OUT!" I couldn't believe when I suddenly saw an adorable little face. His body quickly followed. Baby went right to Mom, making very little noise, but doing ok. Mom pushed for less than 6 minutes and once the baby was born, she was like a different person. The pain ended abruptly. She of course had new pain, but it didn't seem so bad. It was probably an hour before the baby boy was taken from Mom. All assessments were done in her arms. I was amazed at how quickly this little boy was interested in nursing. He was giving very clear cues within minutes of his birth. He nursed as soon as he was ready.
I stayed with the family long enough to see how much the baby weighed and decided it was best to let the family enjoy this time. This is the first baby I have ever seen born and I will never forget it. Although there was a time during Mom's yelling when I was glad I had never done it, the overall feeling I had was that it just made sense. What I watched was the way nature intended it to happen. It was amazing. I am forever grateful to this family for allowing me to be a part of the birth of their baby. I am honored to have been a witness to his birth and will never forget this experience. What a great job these nurses have to witness such an amazing event so often in their lives.
Monday, January 18, 2010
Why Indeed
Tonight, as I began my reading, I couldn't help but think about the task that lay ahead of me. I believe that to be a good childbirth educator, you must be an activist to some degree. This is something I have never done and am cautious about becoming. I don't want to tell anyone that my way is the right way and their way is wrong. What I want to do is inform women of the evidence while being an agent of change in the current obstetrical system. I haven't quite figured out how I'll accomplish this goal.
The articles I read tonight were originally printed in Birth, entitled "Why do women go along with this stuff?" and are a two part roundtable discussion. While the articles focused on a variety of issues, I was most struck by the overwhelming task that is changing standard obstetrical practices and making them safe for all women. As proud Americans, we often think that we have the best medical care available and obstetrics should be no exception, but we're not the best in this instance. As of 2009, there are 44 countries with better infant mortality rates, including Cuba, European Union, Italy, Taiwan, Greece, Ireland, Canada, New Zealand, United Kingdom, Portugal, Australia, Netherlands, South Korea, Israel, Spain, Switzerland, Germany, Hong Kong, Japan, Sweden and Singapore (CIA World Factbook). Many of those countries use the midwifery model of care. I believe it would be in the best interest of most women that obstetricians begin to use this model of care for low-risk pregnancies and leave the high-technology, heavy-intervention care to those at high-risk.
This is a seemingly impossible task and with good reason. Penny Simkin says "[w]e must realize that each woman is a transient stakeholder in the maternity care system..." This is so true. Most women are pregnant for a short period of their lives and don't think much about the maternity system after they are done having children. Simkin also says that "[i]t is unlikely that a powerful consumer movement will materialize, because most consumers move on to other interests and obligations after completing their childbearing. (A few thankfully, remain involved, becoming birth activists, writers, doulas, childbirth educators, or care providers.)" It is very important to keep this in mind with the difficult task ahead. The total change may not happen, but if the effort is never made, we'll never know.
In the second article, Carol Sakala of Childbirth Connection says that "women don't know what they don't know." This seems like an obvious statement, but is the reason I am becoming a childbirth educator. I had no idea how much the typical information was driven by factors and agencies that ultimately don't have mom's and baby's best interest in mind. I could go on forever about it, but I won't do that now. The issue is how do we teach women what they need to know? How do we help them sort through the enormous amount of material out there and determine fact from fiction. I can't say it enough: I don't want to make decision for anyone else, but want to make sure that families have the correct information to make their own decisions.
I'm not sure where that leaves us for now. There's a lot of work to be done and a lot to think about. My next post will focus on some interesting observations I've made about my beliefs and actions while competing The Birth Survey.
References:
Kitzinger, S., Gree, J.M., Chalmers, B., Keirse, M.J., Lindstrom, K., & Hemminki, E. (2006). Roundtable discussion: Part 1 - Why do women go along with this stuff? Birth, 33 (2), 154-158
Klein, M.C., Sakala, C., Simkin, P., Davis-Floyd, R., Rooks, J., & Pincus, J. (2006). Roundtable discussion: Part 2 - Why do women go along with this stuff? Birth, 33 (3), 245-250.
CIA World Factbook. Viewed January 18, 2010.
The articles I read tonight were originally printed in Birth, entitled "Why do women go along with this stuff?" and are a two part roundtable discussion. While the articles focused on a variety of issues, I was most struck by the overwhelming task that is changing standard obstetrical practices and making them safe for all women. As proud Americans, we often think that we have the best medical care available and obstetrics should be no exception, but we're not the best in this instance. As of 2009, there are 44 countries with better infant mortality rates, including Cuba, European Union, Italy, Taiwan, Greece, Ireland, Canada, New Zealand, United Kingdom, Portugal, Australia, Netherlands, South Korea, Israel, Spain, Switzerland, Germany, Hong Kong, Japan, Sweden and Singapore (CIA World Factbook). Many of those countries use the midwifery model of care. I believe it would be in the best interest of most women that obstetricians begin to use this model of care for low-risk pregnancies and leave the high-technology, heavy-intervention care to those at high-risk.
This is a seemingly impossible task and with good reason. Penny Simkin says "[w]e must realize that each woman is a transient stakeholder in the maternity care system..." This is so true. Most women are pregnant for a short period of their lives and don't think much about the maternity system after they are done having children. Simkin also says that "[i]t is unlikely that a powerful consumer movement will materialize, because most consumers move on to other interests and obligations after completing their childbearing. (A few thankfully, remain involved, becoming birth activists, writers, doulas, childbirth educators, or care providers.)" It is very important to keep this in mind with the difficult task ahead. The total change may not happen, but if the effort is never made, we'll never know.
In the second article, Carol Sakala of Childbirth Connection says that "women don't know what they don't know." This seems like an obvious statement, but is the reason I am becoming a childbirth educator. I had no idea how much the typical information was driven by factors and agencies that ultimately don't have mom's and baby's best interest in mind. I could go on forever about it, but I won't do that now. The issue is how do we teach women what they need to know? How do we help them sort through the enormous amount of material out there and determine fact from fiction. I can't say it enough: I don't want to make decision for anyone else, but want to make sure that families have the correct information to make their own decisions.
I'm not sure where that leaves us for now. There's a lot of work to be done and a lot to think about. My next post will focus on some interesting observations I've made about my beliefs and actions while competing The Birth Survey.
References:
Kitzinger, S., Gree, J.M., Chalmers, B., Keirse, M.J., Lindstrom, K., & Hemminki, E. (2006). Roundtable discussion: Part 1 - Why do women go along with this stuff? Birth, 33 (2), 154-158
Klein, M.C., Sakala, C., Simkin, P., Davis-Floyd, R., Rooks, J., & Pincus, J. (2006). Roundtable discussion: Part 2 - Why do women go along with this stuff? Birth, 33 (3), 245-250.
CIA World Factbook. Viewed January 18, 2010.
Monday, January 11, 2010
Where do we go from here?
It has been a while since my last post. Around the holidays, I found myself needing to sort some things out in my mind and my life before continuing with my studies. Here's where I'm at: It's ok to be done having kids. I've been pregnant twice, had two great pregnancies and have two healthy, amazing kids.
That takes care of the personal stuff. Now for the professional dilemma. To be a nurse or not to be a nurse. For the past few years, this has been the question. I am currently observing childbirth classes at a local hospital (more on this later). I have noticed that there is somewhat of a disconnect or uneasiness in the relationship between childbirth educators and doctors and nurses. I've considered midwifery, but am honestly not sure that I want that much responsibility in the birthing process. Being a nurse at a hospital may bridge the gap for me personally between childbirth educators and labor and delivery nurses and doctors, but it would not address the larger issue. Why is there tension in this relationship?
There is a nurse practitioner in the class that I am observing. The instructor admitted to her that it makes her nervous when health care professionals are in her class. I can understand why, but the childbirth educator should take pride in what she does and be confident in her preparation, knowledge and competency to be teaching.
I must admit that when I researched the certification process, I thought "certification will be a breeze." I am enjoying every bit of my studies, but am cramming a whole lot of information into the span of about 7 months. Thankfully, I am engaged in the material and able to thoroughly complete my work in the time I have. This is a lot of work. I am sure that others could skim, hand pick what they will read and still complete the certification process. I am currently enjoying life as a sponge. I'm taking in everything I can. This is a passion. This is a journey. This is a lifetime of work. Certification is not a breeze, at least not for me. It is 100% worth it. With all that being said, I feel as though I will be prepared for the tasks that lay ahead. I will definitely have "first time jitters" and learn as I go. I don't claim to know everything and will always have something to learn. I hope, however, that by the time I'm 10+ years into my career, that I don't let health care professionals intimidate me.
No, this is not a degree. That is a little bit of a struggle for me and a place where I can see the doctor/nurse/childbirth educator relationship becoming a little hairy. I do have a degree in math, a certification to teach and soon a certification in childbirth education. With all that though, I think that we should all be able to find our place in this relationship. With collaboration, big changes could and should be made. It's not about the relationship of "childbirth professionals," it's about families expanding and supporting them throughout that transition as a team.
With all of that being said, I wonder if I should become a nurse a few years down the road or stand tall and proud as a confident childbirth educator without being a nurse. So many educators and future educators have what I've heard described by one as "nurse grief." I get it. But, how do we fix it.
I am currently 4 classes into a 7 week childbirth series. The first 3 weeks were great. Everything seemed to jive with what I was learning. This past week, we talked about the birth and hospital procedures. I was disappointed in the way that some information was presented, as it was clearly indicative of hospital policy and not necessarily the best interest of mom or baby. I would take a position as a childbirth educator in a hospital, but will work towards private practice in the future. There has to be a way to reach women outside of the hospital and make them aware of the evidence and their rights before they have to make choices. Many people are not aware that there are choices. I've said it again and again, it's about making the right choices for you and your family. You can't make the right choice without factual information. It is far too easy to teach to hospital policy, much like the teaching to the test I experienced as a public school teacher. I don't think I can do that again. It's not fair to the educator and it's definitely not fair to the student. I have to do more digging on the hospital's policy regarding the childbirth education classes. I'm not sure whether there is a set curriculum or if it is left to the individual instructors.
I am so thankful for the opportunity to observe and the instructors willingness to answer questions. I am thankful for her asking for my opinion and input when she feels like it would be helpful. I am learning a lot and getting some great ideas on instruction techniques. While I don't think courses should be taught according to hospital policy, I do see where it would be helpful to know what is standard in the setting that women will be giving birth. Equally important is to know that "standard" doesn't mean "necessary." I'm anxious to see if and when informed decision making will come into play in these classes.
That should be enough for now! I hope to be back more often now that I'm back on track with my studies. I'm making great progress and looking forward to what this profession has in store for me.
That takes care of the personal stuff. Now for the professional dilemma. To be a nurse or not to be a nurse. For the past few years, this has been the question. I am currently observing childbirth classes at a local hospital (more on this later). I have noticed that there is somewhat of a disconnect or uneasiness in the relationship between childbirth educators and doctors and nurses. I've considered midwifery, but am honestly not sure that I want that much responsibility in the birthing process. Being a nurse at a hospital may bridge the gap for me personally between childbirth educators and labor and delivery nurses and doctors, but it would not address the larger issue. Why is there tension in this relationship?
There is a nurse practitioner in the class that I am observing. The instructor admitted to her that it makes her nervous when health care professionals are in her class. I can understand why, but the childbirth educator should take pride in what she does and be confident in her preparation, knowledge and competency to be teaching.
I must admit that when I researched the certification process, I thought "certification will be a breeze." I am enjoying every bit of my studies, but am cramming a whole lot of information into the span of about 7 months. Thankfully, I am engaged in the material and able to thoroughly complete my work in the time I have. This is a lot of work. I am sure that others could skim, hand pick what they will read and still complete the certification process. I am currently enjoying life as a sponge. I'm taking in everything I can. This is a passion. This is a journey. This is a lifetime of work. Certification is not a breeze, at least not for me. It is 100% worth it. With all that being said, I feel as though I will be prepared for the tasks that lay ahead. I will definitely have "first time jitters" and learn as I go. I don't claim to know everything and will always have something to learn. I hope, however, that by the time I'm 10+ years into my career, that I don't let health care professionals intimidate me.
No, this is not a degree. That is a little bit of a struggle for me and a place where I can see the doctor/nurse/childbirth educator relationship becoming a little hairy. I do have a degree in math, a certification to teach and soon a certification in childbirth education. With all that though, I think that we should all be able to find our place in this relationship. With collaboration, big changes could and should be made. It's not about the relationship of "childbirth professionals," it's about families expanding and supporting them throughout that transition as a team.
With all of that being said, I wonder if I should become a nurse a few years down the road or stand tall and proud as a confident childbirth educator without being a nurse. So many educators and future educators have what I've heard described by one as "nurse grief." I get it. But, how do we fix it.
I am currently 4 classes into a 7 week childbirth series. The first 3 weeks were great. Everything seemed to jive with what I was learning. This past week, we talked about the birth and hospital procedures. I was disappointed in the way that some information was presented, as it was clearly indicative of hospital policy and not necessarily the best interest of mom or baby. I would take a position as a childbirth educator in a hospital, but will work towards private practice in the future. There has to be a way to reach women outside of the hospital and make them aware of the evidence and their rights before they have to make choices. Many people are not aware that there are choices. I've said it again and again, it's about making the right choices for you and your family. You can't make the right choice without factual information. It is far too easy to teach to hospital policy, much like the teaching to the test I experienced as a public school teacher. I don't think I can do that again. It's not fair to the educator and it's definitely not fair to the student. I have to do more digging on the hospital's policy regarding the childbirth education classes. I'm not sure whether there is a set curriculum or if it is left to the individual instructors.
I am so thankful for the opportunity to observe and the instructors willingness to answer questions. I am thankful for her asking for my opinion and input when she feels like it would be helpful. I am learning a lot and getting some great ideas on instruction techniques. While I don't think courses should be taught according to hospital policy, I do see where it would be helpful to know what is standard in the setting that women will be giving birth. Equally important is to know that "standard" doesn't mean "necessary." I'm anxious to see if and when informed decision making will come into play in these classes.
That should be enough for now! I hope to be back more often now that I'm back on track with my studies. I'm making great progress and looking forward to what this profession has in store for me.
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