The Power of Childbirth Education as a Gateway to Making Changes in Maternal and Child Health Tamara...
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- The Power of Childbirth Education as a Gateway to Making Changes in Maternal and Child Health Tamara Wrenn, MA, CCE Just Us Women Productions, LLC P.O. Box 744 Harriman, NY 10926-0744 917-945-0765 www.JustUsWomen.org
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- 2 My Philosophy of Childbirth Education Pregnancy is not an illness but a normal part of a womans lifecycle. Unless her pregnancy, labor or birth deviates from a natural & predictable physiological course she should be encouraged, supported and empowered to use her inner strength and instincts to give birth with a conservative use, if any, of medical and technological interventions.
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- 3 Setting the framework Approach childbirth education as a scientific discipline whose major concerns are helping expectant parents prepare for an optimal birthing experience and learning skills that will enhance wellness throughout life (Nichols, 2000).
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- 4 National Healthy Start Association The National Healthy Start Association believes that the Healthy Start program offers the best models for the reduction of infant mortality, low birth weight and racial disparities in perinatal outcomes. This model emphasizes both the importance of community-based approaches to solving these problems, and the need to develop comprehensive, holistic interventions that include health, social and economic services. Each Healthy Start project is mandated to develop a local consortium composed of neighborhood residents, medical providers, social service agencies, faith-based representatives and the business community. This consortium guides and oversees the design and implementation of the local Healthy Start project.
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- 5 ASK YOURSELF 3 KEY QUESTIONS Is your Healthy Start project where you want it to be? Is your Healthy Start project where it needs to be? Who is on your Healthy Start team?
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- 6 Take Home Message-Food for Thought Certified Childbirth Educators (CCE): trained healthcare specialists skilled in developing evidence based curriculums that support the needs of mothers. in collaboration with Healthy Start have the capacity to identify and address the specific perinatal health needs of a target population for the purpose of improving behavioral, policy and systems changes; and improving client self-efficacy and decision making skills. through the use of a conceptual framework the interdisciplinary maternal child health team, inclusive of a CCE, can expand the use of evidence based practices in childbirth education.
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- 7 Healthy People 2010 16-7. (Developmental) Increase the proportion of pregnant women who attend a series of prepared childbirth classes. Potential data sources: National Pregnancy and Health Survey, NIH, NICHD; National Survey of Family Growth (NSFG) or National Health Interview Survey (NHIS), CDC, NCHS. As part of comprehensive prenatal care, a formal series of prepared childbirth classes conducted by a certified childbirth educator is recommended for all women by the Expert Panel on the Content of Prenatal Care. These classes can help reduce womens pain and anxiety as they approach childbirth, making delivery a more pleasant experience and preparing women for what they will face as they give birth. A full series of sessions is recommended for women who have never attended. A refresher series of one or two classes is recommended for women who attended during a previous pregnancy. At a minimum, the childbirth classes should include information regarding the physiology of labor and birth, exercises and self-help techniques for labor, the role of support persons, family roles and adjustments, and preferences for care during labor and birth. The classes also should include an opportunity for the mother and her partner to have questions answered about providers, prenatal care, and other relevant issues, as well as to receive information regarding birth settings and cesarean childbirth. Attendance is recommended during the third trimester of pregnancy so that information learned will be used relatively soon after presentation. Classes should begin at the 31st or 32nd week and be completed no later than 38 weeks. The refresher class should be completed at any time between 36 and 38 weeks. Source: http://www.healthypeople.gov/Document/HTML/Volume2/16MICH.htm#_Toc494699663
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- 8 Healthy People 2010 Mid-Year Review Objectives that could not be assessed. At the time of the midcourse review, data to assess progress were unavailable for childbirth classes (16-7). As stated in Healthy People 2010, "Most developmental objectives have a potential data source with a reasonable expectation of data points by the year 2004 to facilitate setting 2010 targets in the mid-decade review. Developmental objectives with no baseline [or data source] at the midcourse will be dropped." Although some developmental objectives with no baseline data or data source were deleted as part of the Midcourse Review, the U.S. Department of Health and Human Services and the agencies that serve as the leads for the Healthy People 2010 initiative will consider ways to ensure these emerging public health issues retain prominence despite their current lack of data. Source: http://www.healthypeople.gov/data/midcourse/html/focusareas/FA16ProgressHP.htm
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- 9 Mothers surveyed who took childbirth education classes (CBE) 70% said the classes helped them to better communicate with their caregivers Source: Listening to Mothers Survey II Report of the Second National US Survey of Womens Childbearing Experiences Childbirth Connection # Surveyed Participated in CBE Total 1,57325% 519 first time mothers 56% 1,054 experienced mothers 9%
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- 10 Definition of a Certified Childbirth Educator A certified childbirth educator (CCE) is a health specialist trained to be a resource and guide for women on issues of pregnancy, labor and birth. They are responsible for providing balanced information to clients that is accurate and evidence-based, including identifying social systems and policies based on the risks and benefits they pose to maternal, infant and child health and wellness. CCEs work with clients so that they can become informed decision makers in their own health care practices and choices.
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- 11 Advocates The childbirth education movement was impacted early on by social, political and feminist influences. International Childbirth Education Association (ICEA) was founded in 1960. It began as a federation of local consumer groups convened by the Maternity Center Association (now Childbirth Connections). Its motto was Parents and professionals working together to provide parents with the knowledge of alternatives to make informed choices. The catalyst for national chapters of CEA.
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- 12 Leaders ASPO/Lamaze Summit on Childbirth and Perinatal Education in Chicago 1994. Top three conclusions-1) increase the confidence women have in themselves and their ability to give birth without unnecessary interventions: 2) to increase the control women have over their healthcare and education; and 3) to improve the physical and psychological outcomes or pregnancy (Nichols, 2000). Inclusion of childbirth education in HP 2010 goals organized by Lamaze international. Encouraged childbirth educators to begin a letter writing campaign to project committee members. It was included in the draft and subsequently adopted (Nichols, 2000).
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- 13 Teachers Example of 2007-2008 curriculum offered by Childbirth Education Association of Metropolitan NY, Teacher Certification Program HISTORY OF CHILDBIRTH; INDUSTRIALIZATION TO THE PRESENT ANATOMY & PHYSIOLOGY OF PREGNANCY, LABOR & BIRTH TEACHING BREASTFEEDING NUTRITION & FETAL DEVELOPMENT MEDICATIONS IN PREGNANCY, LABOR & BIRTH OBSTETRICAL TESTING AND PROCEDURES CESAREAN BIRTH & PREVENTION TEACHING LABOR SUPPORT USE OF ALTERNATIVE THERAPIES IN LABOR AND BIRTH; ACUPUNCTURE, HERBS, MASSAGE AND BREATH WORK TEACHING NEWBORN CARE PAIN COPING STRATEGIES FOR LABOR & BIRTH MATERNAL POSTPARTUM ISSUES PERINATAL LOSS PUBLIC SPEAKING TEACHING TECHNIQUES
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- 14 Change Agent Childbirth Connections (formerly Maternity Center Association) Used its nurse-midwifery service in1948 to provide natural childbirth classes emphasizing exercise, breathing and relaxation for the prenatal period and labor and birth (Ettinger, 2006). Conducted first natural childbirth demonstration projects in Connecticut and New York. Nurse-Midwives taught a series of six-prenatal classes; one lecture and two exercise classes during the early stages of pregnancy and another lecture and two exercises during the last month on labor and birth (Ettinger, 2006).
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- 15 Little Known Fact During a low risk pregnancy A traditional certified childbirth educator spends 15-18 hours with a client over a 5- 6 week period in her third trimester alone. Prenatal care providers spend about 2-3 hours with a client over the course of her pregnancy during the routine 10 to 15 minute office visit (averages 13 visits).
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- 16 Financial Costs-The potential for impact Total 2002 Medicaid Births 1,661,320 Source: Kaiser Family Foundation, www.statehealthfacts.org/comparemaptablewww.statehealthfacts.org/comparemaptable Average Health Educator Cost Annual Median $41,330 Source: US Department of Labor Certified Childbirth Educators Annual Median $49,008 Source: www.swz.salary.com/salarywizrdwww.swz.salary.com/salarywizrd Cost for Cert