Shari McBurney Certified Childbirth Educator (BACE) Certified Labor - - PowerPoint PPT Presentation
Strategies for impact in childbirth education Shari McBurney Certified Childbirth Educator (BACE) Certified Labor Doula (TOLABOR) A proactive look at Change Current Agents Historic recommendations of Change role of and resources CBE
Strategies for impact in childbirth education
Shari McBurney
Certified Childbirth Educator (BACE) Certified Labor Doula (TOLABOR)
A proactive look at Change
Historic role of CBE Current recommendations and resources
Simkin
Agents
Impetus to update, refresh and inspire Strategies for impactful CBE
From whence we came...
○ By 1938 - 50% gave birth in hospitals ○ By 1955 - 99%
1900 to 1940s 1950 to 1960s
1970 To 1980s
○ Preparation for birth rather than natural childbirth methods
Present
Listening to Mothers
○ 53% of mothers had taken a class either with this pregnancy or a prior one ○ Of those that took classes, 59% are new mothers
○ 49% weekly classes ○ 24% one-day ○ 26% two-day ○ 82% took hospital-based classes ○ 37% took class to learn about “natural birth”
Recent ACOG Publications
○ 6cm is the new active labor! ○ Redefined: “abnormal” first stage labor ○ Labor induction >41w, unless medically indicated ○ Later Cesarean call for prolonged labor or pushing ○ Provide manipulation if possible for malposition ○ Continuous labor support ○ Stay at home until “active labor” ○ Intermittent monitoring ○ Continuous support ○ Stay hydrated ○ Avoid AROM ○ Use various positions for labor and pushing ○ Use non-pharm methods for comfort ○ Await urge to push/passive descent
CBE is absent as a method in both publications… because:
“Insufficient evidence exists as to whether antenatal education in small classes is effective in regard to
psychosocial
C a r e P r
i d e r e d u c a t
support
A C O G g u i d e t
r e n a t a l p r a c t i c e f
p r
i d e r s Women
“Desired reforms will occur to a greater degree with active participation by educated expectant parents.”
Collaborative Response to ACOG Committee Opinion #687
Dilemmas of Childbirth Educators
birth-related information, behavior and attitudes… much of it misinformation
evidence-based information
direct/indirect childbirth experiences
○ Shorter classes ○ Interpersonal connection vs info to impart ○ Accessibility/inclusion ○ Availability
○ Positive birth experience? ○ Advocacy for a particular type of birth?
○ Lack of interprofessional education ○ Curriculum out of date
We struggle to build... We grapple with goals... They know too much
“Reducing the childbirth experience to a series of stages, phases,
trust her inner wisdom and find her own path.”
A Paradigm of Normal Birth: Teaching Through the Healthy Birth Practices
parents to see themselves as valued members of the maternity care team
part of this journey
your content
framework for change
testing
measures
preparation
decision making
postpartum
adjustment
choices
○ Simkin’s response ○ Childbirth Connection Recommendations
parents?
teaching topics in the realm of care options?
Selected evidence-based recommendations from ACOG 2017 Challenges for parents (that might be reduced with prior education) Childbirth education may equip parents to improve outcomes by teaching Suggested actions and objectives Delay hospital admission until active labor After hours of contractions at home, many parents go to the hospital too soon. On arrival, the cervix may not be dilated enough to merit admission; they may be sent home: worried, confused or angry
progressing contractions
Clinical
Acknowledging challenges will help clarify your goal Suggestions Actions
interprofessional collaboration
Shari McBurney
Certified Childbirth Educator (BACE) Certified Birth Doula (TOLABOR)