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Tag continuing education

Spotlight on Rebecca Dekker and Evidence Based Birth™

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Working through the multitude of childbirth care options and decisions during pregnancy and labor can be a daunting task.   Pregnant women and their families can often be overwhelmed when faced with some of the various tests, suggested procedures or interventions that are offered or recommended to them prenatally or while laboring.

Rebecca Dekker, PhD, RN, APRN is one of those women whose first time through the gate left her feeling uneasy, so she started asking questions and seeking answers.  Rebecca felt that some of the restrictions that were in place during the birth of her daughter had not worked in her favor. She began to wonder if they had truly been needed.  Was it really imperative that she not be allowed to eat or drink during labor? Was the risk of cord prolapse great enough to justify the bed rest that kept her from being more upright and active during labor? Being a researcher and a nurse herself, Rebecca set to work investigating the basis for some of the recommendations that she took for granted were based on clear evidence. It turns out that the evidence was scant for some of the policies and procedures she had assumed were necessary and that realization prompted her to do things differently with her second child.

Armed with new information based on the all of the good quality research she could get her hands on, in her second pregnancy, Rebecca placed herself firmly in the driver’s seat and sought out care that was supported by medical evidence. After her son’s birth, she felt the opposite of uneasy, and instead, she felt she could do anything!  She followed her gut and turned her newfound bursts of inspiration into something that would help others gain information to more easily navigate the birth care maze. Rebecca’s story is not uncommon. Many women have their minds and hearts jostled a bit during their first birth experience when things either don’t go as planned, or the overall experience is not what they had envisioned. As a long time postpartum support group facilitator, I have personally seen countless new mothers do a lot of rethinking of the choices they made, especially in regard to interventions or care they felt they had no choice about or did not quite understand the real risks or advantages of.

All of this questioning and examination usually yields good results.  And, fortunately, for all of us out there who care about improving maternity care and providing pregnant women with quality information to help make decisions about their care, Rebecca used her experience, skills and research and took big action. Her website, Evidence Based Birth™ , is a virtual treasure trove of birth related research, distilled down into forms that the non-researcher can easily understand and utilize.

The EBB website offers, a long list of articles in Q & A blog format, printable documents, video-based online classes that include continuing education credits and a newsletter. Subjects are well organized and can be accessed using an alphabetized topic list.

I had the opportunity to speak with Rebecca on the phone and was able to ask her a few questions about her new venture, which has garnered a fair amount of attention in a short amount of time since she launched the site in 2012. Some of the recent or upcoming topics she is working on which include Vitamin K for newborns, moxibustion for turning a breech baby and the oft cited ‘failure to progress’ as a reason for birth interventions.

When asked what she felt was one of the best things a pregnant woman could do with the content available on her website as far as taking action, Rebecca said that using the data and information to choose a care provider that they feel will provide evidence-based care was at the top of the list. I agree wholeheartedly with this because a woman who exercises her power to purposefully choose a care provider that supports the vision she has for her birth is a key element to a positive experience.  In addition to birthing women, Rebecca’s EBB website resources are highly desirable and useful to childbirth educators, doulas and other birth and medical professionals in the work they do with clients prenatally, during birth and postpartum.

With less than stellar maternal and infant mortality rates here in the US, there is much discussion in the birth world about finding ways to improve these results. It is challenging finding a balance between expecting the maternity care system to take responsibility for ensuring, quality, evidence-based care for all while simultaneously urging pregnant women to take responsibility for learning as much as they can in order to make informed decisions about who and how they are cared for when they give birth. Both of these things are important.  I love that Rebecca has made it easier for all of us to access and understand the research that is out there in order to get a clearer picture of the path that seems best for a woman in her own unique situation.  So if you are trying to find your way (or help others) to the birth you desire and feel lost and uncertain about which way to go, bring your questions to Evidence Based Birth™

and you may just find the answers you are looking for.

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Note: My interview with Rebecca was the inspiration for an article I recently wrote for Peggy O’Mara’s website about evidence based medicine as it relates to birth.  Click here to read it.  As the long time editor of Mothering magazine and founder of mothering.com, Peggy has been a tireless advocate for women and families as well as the author of several wonderful books. At her new self-titled website, she continues to curate and create great content about natural family living, social justice and making healthy choices. I highly recommend this site as a place to spend time reading about and digging into issues that are near and dear to all of us who want to live well and support positive change in the world.

 

 

Mammals Suck…Milk! at Harvard with Katie Hinde

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Breastfeeding is one of the most politically hot topics of our day. The subject cuts across some touchy areas: breast milk v. formula, work v. stay-at-home, how long is enough? Oh, and don’t forget breastfeeding in public or breast milk selling and sharing. Weigh in on any one of these discussions and you are pretty much guaranteed to piss-off at least a few people in any setting, no matter your point of view.

So…what if there was a way to consider breastfeeding without so many of the usual political or personal filters put on the topic? Well, earlier this month at the Harvard Science Center I was pleased to sit in on a lecture about lactation that seemed, to me anyway, to have done just that. The presentation was given by Katie Hinde, PhD, Assistant Professor in the Department of Human Evolutionary Biology at Harvard University, and it was a lay-persons review of some fascinating scientific studies digging into what we know and most notably, what we don’t know, concerning the way in which mammals breastfeed their young and the value of the milk (and the mother-infant interaction) to the development of the young.

In her presentation Katie discussed research on how the composition and quantity of rhesus macaques monkey milk varied depending on the sex of the baby monkey, analysis on the purpose and effect of various milk components such as oligosaccharides, cortisol and bacteria. We learned that the mother naturally creates different types and amounts of milk for sons and daughters and that the components in mammal milk are widely varied, vast and largely unknown. Throughout the presentation it became clear that the extremely limited knowledge we have today about what these components are and what they actually do is only the tip of a fascinating iceberg.

Some of the other interesting aspects of the research Katie was highlighting included the intertwined elements of nutrition and socialization for the monkeys. One point, which jumped out at me, dealt with the scientific research process itself. In that, to study the natural behavior of mammals such as the macaque monkeys it is impossible to separate the socialization and the feeding. I found that a notable reminder that there is more going in with infant feeding than simple milk transfer. It was also really thought provoking to consider the various resource trade offs that were occurring for a monkey mother based on the age and size she was at each of her pregnancies.

Overall, I came away with a renewed sense of wonder about how closely linked maternal and child development really are and how little we understand about the dynamics in play. I am in no way fluent in human evolutionary biology so I am not going to try and break down this awesome science because that would be really embarrassing for me. Do, however, go and check out Katie’s blog posts on sex biased milkmilk and behavior, the Comparative Lactation Lab, her chuckle worthy twitter feed @Mammals_Suck, or any of her published research if  you want to geek out on this stuff as it is well worth a look. And don’t blame me if you get hooked on it because I am warning you, Katie makes things really fun and interesting. I mean, who can resist the competitive challenge of filling out your picks and cheering on your favorite mammals in a basketball bracket style twitter game of Mammal March Madness? Trust me, this is a blast and educational to boot so keep your eye out for the 2014 version that will launch in, you guessed it, March of 2014.

It was fascinating to consider how all this works in nature and for an hour or so to strip out a lot of the noise contributed by the modern human response to the topic of breastfeeding. I look forward to following Katie’s work as well as keep my ear to the ground for other, similar research underway – sometimes, just maybe, mother nature is the best teacher, after all, she has had millions of years to perfect her lesson plans.

A special shout out to Diana Cassar-Uhl, IBCLC for initially introducing me to Katie’s work!

Katie and I at the end of her talk which I will link when the link is available.

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Great Day Spinning Babies

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Spinning Babies Workshop – Easier Childbirth with Fetal Positioning

On October 7, 2013 I had the opportunity to attend one of Gail Tully’s Spinning Babies workshops, it was sponsored by BACE/NMC.

What an event! Gail’s workshops are very popular and the attendees universally rave about them, so I knew that the information and format of the event would be good.  The focus of the day was on fetal positioning, a comprehensive look at how to support optimal positioning, and the best methods to assist a mother in making space for her baby to ‘spin’ into a better position for birth.

Anatomy, posture, exercises for releasing ligaments, muscles and fascia,labor patterns, real life stories, aids and tools, complementary body work suggestions and related research and were all part of the discussion.  To be honest I was blown away by the vast amount of really useful information I had never heard before and it was clear that Gail is in command of her subject!

To give you a sense of it, here are a few things that stood out to me in regard to why this was such a quality continuing education offering.

Gail had a very approachable presentation style that really showcased her extensive experience and high-level knowledge.  Although it was clear that she has done the day-long workshop many times, Gail worked through her material like a talented musician would give a concert.  She moved in and out and around her script and adjusted the presentation to the attendees in the room and the questions presented with ease and kept us engaged.

Gail also is clearly a creative thinker so her talk was filled with really well though out visual aids and props that were an amazing part of her ability to convey (and help me to easily visualize and remember) what she was explaining.

There was also a noticeable element to Gail’s overall outlook and approach to birth that included a strong dose of intuition and recognition of the mother’s emotional state as a crucial element of all that is in play when a woman is laboring.  Being someone that feels that it is essential to look at physiologic birth in a holistic way, this resonated with me.

I was thrilled to get this great photo of Gail and I at the end of the day.

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You can check out Gail’s program here.

To summarize: If you are out there helping mothers birth their babies and haven’t been to one of Gail’s workshops, run, don’t walk, to the nearest upcoming event And for anyone interested in learning more, take a look at all the great content on her website including this great article on belly mapping.

 

Keeping Current With Online Continuing Education

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More and more quality online continuing education offerings are popping up out there and I wanted to highlight a few coming up that look really worthwhile.

  • Evidence-Based Care for Suspected Big Babies: 

Rebecca Dekker, PhD, RN, APRN of Evidence Based Birth has launched her first video-based class entitled Evidence-Based Care for Suspected Big Babies.  This is an in-depth course with several video lectures and handouts that is worth 2 nursing contact hours. More offerings are slated for later in the year so keep an eye on her site or sign up for her newsletter if you want to be in the know on what the upcoming topics will be.

  • Social Media for Lactation Professionals:  Skills to Maximize: 

Praeclarus Press has two webinars coming up in October, 2013.  The first is Social Media for Lactation Professionals:  Skills to Maximize featuring Lara Audelo, CLEC author of The Virtual Breastfeeding Culture:  Mother-to-Mother Support in the Digital Age 

  • Welcoming African American women into your practice: Seven steps to creating a culture of respect and inclusivity: 

The second offering from Praeclarus Press is entitled Welcoming African American women into your practice: Seven steps to creating a culture of respect and inclusivity with featured speaker is Sherry L. Payne, MSN, RN, CNE, IBCLC of Perinatal ReSource 

  • An Integrative Approach to Tongue-tie, Lip-tie & Breastfeeding: the Interdependent Roles of the Lactation Consultant, Surgeon & Bodyworker: 

Another interesting offering is with Jennifer Tow, BFA, IBCLC, in collaboration with Larry Kotlow, DDS scheduled for October 21 and 22, 2013. This two part webinar is called AnIntegrative Approach to Tongue-tie, Lip-tie & Breastfeeding: the Interdependent Roles of the Lactation Consultant, Surgeon & Bodyworker

 

These are just a few of the online lectures, courses or webinars that I have seen available Fall 2013.  I love in person conferences and seminars but the internet makes hearing the latest info from leading professionals out there easy and convenient. Check them out!