The authors take a look at a large number of common interventions during labor and delivery and determine if they are supported by evidence or not.
One of the things they looked was using a partogram. Now this is a term I had never heard before. Naturally I had to google it. I don't know if this is the best page to define the term http://staff.um.edu.mt/csav1/lectures/partogram.pdf but it sure has a lot of charts. As best as i understand a partogram is basically a chart with an "action line" and anything that falls into the range of the "action line" requires some kind of action. Something like the Friedman's Curve.
Barbara over at NavalGazingMidwife http://navelgazingmidwife.squarespace.com/ kindly posted this link to an article that gives a good explaination of that http://emedicine.medscape.com/article/273053-overview
Something I'm going to have to learn more about for sure.
If you're interested they concled that the evidence is insufficient to recommend routine use of the partogram.
With all the excitement over international day of the midwife I'm a bit late celebrating the doulas. But now that I'm on it:
Just in case you aren't familiar with the word "DOULA", from the homepage of DONA International
The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.
Did you know the benefits of having a doula present at birth is proven by research?
DONA (doulas of north america) goes over the research here http://www.dona.org/resources/research.php and sage birth gives a neat little summary of some of the specific figures here http://sagebirth.com/Doulabenefits.htm
and here are more links:
from the american pregnancy association http://www.americanpregnancy.org/labornbirth/havingadoula.html
from midwife ronnie falcos archives http://www.gentlebirth.org/archives/doulnots.html
from one of my doula friends on facebook
I'm really excited to be reminded of Doula Month. I'm still hoping to do some training in that area as soon as the grant money comes through.
I changed my settings on face book so i don't get a new e-mail everytime anybody sneezes ( :lol)
I unsubscribed to a few newsletters i'm not really interested in anymore.
Hopefully these small steps will help keep it from getting to the point its at now ever again.
Also while going through whats left. i'm doing by the page. I just click "select all" then QUICKLY skim the titles/senders. Very little is making the cut to even be read. Much of what I bother to read can be deleted. And that which I really want to keep I'm labeling into folders so I can find it later.
BABY STEPS BABY STEPS.....
(although i admit i just did a huge step tonight. i have halved my inbox. down from 4000+)
I took the day off work so as to attend as many online discussions/presentations as possible. As an aspiring midwife it was a tremendous opportunity to hear perspectives from midwives who've been at it far longer than I.
I caught a discussion regarding midwives perceptions of working in a birth center. While it wasn't terribly relevant to me now it did reinforce my notion that the hospital birth culture is not currently woman center-ed.
I'm not sure how I feel about having that notion reinforced though. I do feel that midwives are needed as much or more for hospital birth as for home birth. I feel strongly that every woman deserves midwifery model care http://cfmidwifery.org/mmoc/define.aspx
The Midwives Model of Care is
based on the fact that pregnancy and birth are normal life processes.
The Midwives Model of Care includes:
Monitoring the physical, psychological, and social well-being of the
mother throughout the childbearing cycle
Providing the mother with individualized education, counseling, and
prenatal care, continuous hands-on assistance during labor and delivery, and
Minimizing technological interventions
Identifying and referring women who require obstetrical attention
The application of this woman-centered model of care has been proven to
reduce the incidence of birth injury, trauma, and cesarean section.
Copyright (c) 1996-2008, Midwifery Task Force, Inc., All Rights
I can't see how I can take the many years of schooling required to become a CNM (certified nurse-midwife) just to be able to attend hospital births, though. Taking the direct entry route to midwifery and then providing out of hospital birth AND in hospital doula services, childbirth education or other non-medical forms of support for women who prefer to birth in a hospital would allow me to work towards changing hospital birth culture. But it would be quicker and a lot less expensive. I also think i could work "with woman" as a labour and delivery nurse.
So who knows what i'll end up doing?
After that i watched a presentation entitled "Cesarean Delivery on Maternal Request" http://www.slideshare.net/VirtualIDM/cesarean-delivery-on-maternal-request while I listened to The Feminist Breeder's http://thefeministbreeder.com/ podcast interview w/ Amy Romano, Mary Murray and Amie Newman and simultaneously joined the twitterfest @ #idm2010. The feminist breeder's show was dedicated to midwives online presence and tied in nicely to the next presentation "Online Presence for Midwives".
Next up was a session from Gloria Lemay on "Nutrition for Two". Iloved simply Gloria presented the task of eating healthfully. In fact I'm trying to incorporate some of her suggestions into my own eating even though i'm not pregnant.
The presentation on "Fetal Monitoring for Low-Risk Women" went a little over my head at some points but was fascinating nonetheless. I think the important thing I took away was how inportant it is for midwives to learn "high touch/low tech" means of monitoring the mama-baby dyad. These skills are being lost and its up to midwives not to let that happen. If skills like ascultation, palpation, and simple observation are lost what will happen to women when the power goes out? or women who have unplanned out of hospital births?
The drop in sessions for student midwives was a bust but i did enjoy the story telling that took place in its stead.
One session that I missed that I really wanted to participate in was the one about midwifery in South Carolina. That's so close to my location!
Even though these session were mostly targeted towards midwives I came out feeling highly motivationed to get back out in the birth related relms of the internet. (Look, ma! I'm Blogging again!) I'm not a midwife yet but that doesn't mean I don't have a voice to contribute. I have a desire to share what I know and to learn MORE MORE MORE.... and then pass that on.
Additionally I feel motivated to take a few baby steps towards midwifery . I've earned one credential that relates to my midwfery aspirations. Last year I earned my CLC (certified lactation counselor) which I see being really beneficial in postpartum doula work and in childbirth education. Next on my list is to earn my CPR certification and my NRP certification. Beyond that I plan to take advantage of some local networking opportunities. I'm involved in a local Healthy Start group http://www.heartofgeorgiahealthystart.org/ http://www.healthystartassoc.org/ so I want to become more active in that group and make inroads into other groups as well.