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Healthy Native Babies Project
Doula programs serving Native Americans now have a new tool for SIDS prevention. The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) has released for distribution the new Healthy Native Babies Project Workbook Packet. The workbook packet includes updated versions of the workbook and toolkit along with “Healthy Action for Native Babies” handout. These materials have all been revised, based on feedback from training sessions held from 2006 through 2009. The workbook is a comprehensive and up-to-date guide for health professionals, social workers, community organizers, and anyone working in Native communities. The easy-to-read, informative text outlines the facts of SIDS, how to reduce the risk, strategies for reaching communities, and action steps. The toolkit disk allows individuals to design culturally appropriate and regionally specific materials, such as posters, flyers, postcards, and brochures. In addition, there are phrases translated into Native languages as well as photographs of Native families taken across the country to assist communities in delivering customized outreach materials.
The workbook packet can be ordered, free of charge, by calling 800-370-2943 or ordering online at http://www.nichd.nih.gov/publications/pubs_details.cfm?from=&pubs_id=5733.
A facilitator’s packet, with training guides, presentations and activities, and an online self-study module will be available in 2012 to provide additional resources to those working in Native communities.
The Doula Programs blog provides a forum for doula program visionaries and implementers to consider common challenges, ask questions, and learn from each other. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.
PTSD high among new mothers
Nine percent of women in a United States national survey met the criteria for diagnosis of posttraumatic stress disorder following their births, according to new research in the journal Birth. Researchers found that “pressure to have an induction and epidural analgesia,” “planned cesarean birth,” and “not exclusively breastfeeding at one month” were among the predictive variables. Read the abstract.
Each Wednesday, our Birth & Parenting News blog highlights the latest news items, research results, consumer alerts, and legislative action alerts of interest to expectant and new parents and the professionals who work them.
Home Birth is a Safe Option for Healthy Low-Risk Women
In many parts of the world women give birth at home out of necessity for lack of access to a maternity care facility, for economic reasons, or because their cultural traditions have always valued home birth as a social and spiritual life event. In countries where hospital births are the norm, some mothers prefer the privacy, comfort, freedom of movement, and continuity of care that a home birth provides. There is no evidence that hospital birth is safer than home birth for healthy low-risk women.
Women who choose a home birth and the care providers that support them view pregnancy and birth as a normal physiological process in which routine medical interventions are unnecessary. Should a medical complication develop, the use of interventions should be evidence-based. The CIMS Expert Work Group found extensive evidence that supports the safety of home birth. With a home birth, mothers are much less likely to be exposed to medical interventions such as induction of labor, use of IV fluids, continuous electronic fetal monitoring, or amniotomy (breaking the bag of waters). They are also less likely to suffer from infection requiring the use of antibiotics. Perinatal outcomes are similar to planned hospital birth. Without compromising the health and well being of mothers and babies, home birth with maternity care professionals who follow the midwifery model of care also substantially reduces the odds of needing a cesarean section.
Planned home birth is as safe as planned hospital birth for similar groups of women when four important criteria are in place:
- Pregnant women are low risk.
- Home was chosen as the intended place for birth.
- The primary care provider is qualified according to professional licensing standards and trained to assist at home births.
- A collaborative relationship with consulting physicians and a medical center exist, with clear guidelines for continuity of care should a complication arise where the mother or baby would benefit from the transfer.
Home birth gives women more freedom to shape their birth environment but also requires them to take more responsibility for their own care. Women who choose to give birth at home are usually ready to take more responsibility for their care during pregnancy as well as for labor and birth. They are also willing to forgo narcotics or an epidural for pain relief. The World Health Organization recommends that healthy low-risk pregnant women should give birth where they feel safe.
To find out more about a home birth with a midwife visit MANA; ACNM; and Childbirth Connection.
Each Wednesday, our Birth & Parenting News blog highlights the latest news items, research results, consumer alerts, and legislative action alerts of interest to expectant and new parents and the professionals who work them.
Healthy Start and Infant Mortality Prevention
Doula program visionaries should look into the possibility of partnering with federal Healthy Start programs in order to address issues of common concern. The National Healthy Start Association (NHSA), the membership association for the federal Healthy Start programs, promotes the development of community-based maternal and child health programs, particularly those addressing the issues of infant mortality, low birthweight, and racial disparities in perinatal outcomes. As Healthy Start celebrates 20 years of improving infant mortality rates in the communities served, NHSA has released the following new resources:
- Saving Our Nation’s Babies: The Impact of the Federal Healthy Start Initiative chronicles the birth of Healthy Start and NHSA and contains profiles and photographs for over 80 Healthy Start projects.
- Social Emotional Development of Young Children: Resource Guide for Healthy Start Staff focuses on the influence of early childhood experiences and skills on life-long trajectories of health and productivity. Topics include understanding brain development, social emotional development, the life course, and how Healthy Start staff can help parents promote their children’s social and emotional development. The guide was designed with three unique covers as a way to address diversity within communities.
The Doula Programs blog provides a forum for doula program visionaries and implementers to consider common challenges, ask questions, and learn from each other. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.
Pitocin does not reduce cesarean births, forceps deliveries
A recent meta-analysis from the Cochrane Library found that the use of Pitocin during labor does speed labor by an average of nearly two hours but does not reduce the need for cesarean births nor forceps deliveries. Read the Cochrane review.
Each Wednesday, our Birth & Parenting News blog highlights the latest news items, research results, consumer alerts, and legislative action alerts of interest to expectant and new parents and the professionals who work them.
Doulas Should Step Up to Help Breastfeeding Moms
Nearly 75 percent of U.S. hospitals do not fully support breastfeeding. According to the results of a national survey of maternity hospitals and birth centers conducted by the Centers for Disease Control and Prevention in 2009– Maternity Practices in Infant Nutrition and Care (mPINC)–the majority of mothers and babies are not getting the support they need to sustain breastfeeding after leaving the hospital. The CDC surveyed maternity care facilities to ascertain how many of them were implementing maternity care practices outlined by the Ten Steps to Successful Breastfeeding recommended in the Baby-Friendly Hospital Initiative. Implementing the Ten Steps improves the initiation, duration, and exclusivity of breastfeeding.
The U.S. Department of Health and Human Services is highly concerned because infants who are breastfed are less likely to become obese and subsequently to develop elevated cholesterol and blood pressure levels, as well as breathing and joint problems. Mothers who breastfeed are less likely to develop ovarian and breast cancer. The CDC estimates that suboptimal breastfeeding in the U.S. results in $2.2 billion in additional direct medical costs.
Although 92.8% of hospitals provided prenatal breastfeeding education, 89.1% taught new mothers breastfeeding techniques, and 81.8% taught mothers how to recognize and respond to infant feeding cues, less than 15% had a model breastfeeding policy. According to the report, a strong breastfeeding policy is the foundation of quality hospital breastfeeding support and sets standards for the remaining nine steps.
To the detriment of infants, more than 80% of hospitals gave healthy full-term breastfed newborns formula, water, or glucose supplements. Only 26.8% provided adequate breastfeeding support and community resources at hospital discharge. The majority of hospitals implemented only three to five of the ten recommended practices and fewer than 1% implemented all ten recommended policies and practices to promote and support breastfeeding.
The American Academy of Pediatrics recommends exclusive breastfeeding (breast milk with no solids or other liquids except vitamin/mineral supplements or medicine) for about the first six months of infancy and continued breastfeeding with iron-rich foods for at least the first year of an infant’s life.
To facilitate and encourage mothers to breastfeed The Affordable Care Act now includes new insurance guidelines which require insurance companies to cover breastfeeding support, supplies, and counseling. Employers also must provide reasonable break time and a place, other than a restroom, that is private and clean for a mother to express milk.
To support breastfeeding and educate mothers and health care professionals about the benefits of breastfeeding, download the CIMS Breastfeeding Is Priceless: A CIMS Fact Sheet.
Maternity care professionals, employers and the community can help to promote and support breastfeeding by acessing the U.S. Surgeon General’s Guide, Call To Action to Support Breastfeeding and other educational material posted on the CDC website.
The Doula Business Advisor blog is designed to support the establishment and long-term sustainability of private doula businesses. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.
U.S. Needs to Do More About Newborn Death, Study Suggests
Grant writers seeking to fund doula programs can make use of data related to infant mortality when making their case. The number of newborns who died in the first four weeks of life declined worldwide from 4.6 million in 1990 to 3.3 million in 2009, according to a recent report by researchers from the World Health Organization (WHO). However, researchers said the U.S. “isn’t making progress like other countries,” with a newborn death rate higher than 40 other countries at 4.3 for every 1,000 live births. The study, covering 20 years and all 193 WHO Member States was led by researchers from WHO, Save the Children, and the London School of Hygiene and Tropical Medicine. The estimates are based on more data than ever analyzed before and extensive consultations with countries. The study shows detailed trends over time and forecasts potential future progress. Read the full report here.
In 20 years, the U.S. reduced its newborn mortality rate 26 percent, slower than the global average. More than 19,000 newborns still die each year. The U.S. now trails 40 other countries when it comes to risk of newborn death. In 1990, the U.S. had the 28th lowest risk. It is now tied for 41st place with Qatar, Croatia, and United Arab Emirates. All have a newborn death rate of 4.3 per 1,000 live births.
“There are areas of the United States where access to prenatal and preventive care is a real problem. It puts the mother at a disadvantage and contributes to premature births and death rate,” says the study’s author Dr. Joy Lawn of the non-government organization Save the Children.
The study says the leading causes of newborn death worldwide are preterm delivery, asphyxia and severe infections. More than a half million babies in the United States, one in every eight, are born premature each year.
The Doula Programs blog provides a forum for doula program visionaries and implementers to consider common challenges, ask questions, and learn from each other. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.
Baby Shampoo Toxins
Moms who buy special shampoo for their babies probably assume that they aren’t rubbing carcinogens into their precious child’s head during every bath. If they live in the U.S., there’s a good chance they’re wrong. Health and environmental groups have been pressuring Johnson & Johnson to remove two potentially cancer-causing chemicals from its popular baby shampoo, and for some unfathomable reason, they’re dragging their feet.
The company is definitely well aware of the problem. According to the Associated Press, since 2009 The Campaign for Safe Cosmetics has met with Johnson & Johnson representatives three times about making its baby products safer by removing two chemicals. Dioxane, which is considered a likely carcinogen, is found in Johnson & Johnson’s Baby Shampoo, Oatmeal Baby Wash, Moisture Care Baby Wash and Aveeno Baby Soothing Relief Creamy Wash. The shampoo also contains quaternium-15, which releases formaldehyde. Over the summer, the U.S. government officially added formaldehyde, which is used as a disinfectant and embalming fluid, to its list of known carcinogens. It’s also a skin, eye and respiratory irritant. Read more.
Each Wednesday, our Birth & Parenting News blog highlights the latest news items, research results, consumer alerts, and legislative action alerts of interest to expectant and new parents and the professionals who work them.
DONA offers free resources for doulas
Doulas who are members of DONA International will appreciate these great, FREE resources now available in the DONA Boutique:
- From Novice to Expert: The Five Stages of Doula Development. A fascinating look at how doulas experience growth and development of their skills and confidence.
- Third Party Reimbursement Webinar. The “How To” Tutorial on Third Party Reimbursement for Doula Services webinar can now be downloaded from the DONA website. In addition, DONA has prepared a Third Party Reimbursement Packet, which provides information on how doulas can obtain their provider number, along with guidance on the best strategies to request and receive insurance reimbursement for birth and postpartum doula services in the U.S. An electronic version of the packet is FREE to DONA members. Please complete the Survey for each attempt at reimbursement so that DONA can track the success of reimbursement attempts. The Survey form is part of the Packet.
I believe that third party reimbursement for doula services is a key sustainability for doulas. I know none of us enjoys filling out forms, but cultivating the discipline to do so, means that we can all move this agenda along a lot faster.
The Doula Business Advisor blog is designed to support the establishment and long-term sustainability of private doula businesses. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.
Disparity in African-American Infant Deaths
Doula programs that serve high-risk women can be a helpful intervention to address disparities in birth outcomes.
“Any state you look at, you see the same disparities, and race is the strongest predictor of disparities,” says Dr. Deborah Ehrenthal, of Christiana Care Health System in Delaware. “So we see higher rates of infant mortality, higher rates of preterm delivery.” Black women are about 60 percent more likely than white women to deliver babies early and black infants are about 230 percent more likely than white infants to die before their first birthdays. Read the article.
A program that’s showing signs of progress in reducing low birth weight and infant deaths among African-Americans is getting a major vote of confidence. The W. K. Kellogg Foundation has awarded a $4.5 million grant to a program in Grand Rapids called Strong Beginnings.
The Doula Programs blog provides a forum for doula program visionaries and implementers to consider common challenges, ask questions, and learn from each other. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.