Letting others read your drafts

Jun 12th, 2015 Raising Awareness, Research, Training

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When your job is basically to write, you have to let other people read what you write. This is the worst, and best, part of writing.  This week I had to submit my draft dissertation proposal to two professors and the entire grant mock review committee.

I have feedback from the two professors, and I have to admit I’m really happy with the comments.  I think this speaks to the benefit of working through to a third version with three members of my committee before sharing the draft.

Those of you not in the academic community may wonder why so many eyes are helpful for editing.  The reason lies in the differing backgrounds of the outsiders.  My committee and I know my study, and we know what we think my study is.  When we read the proposal we read between the lines and understand terms that may actually be considered jargon.  Inviting people outside my committee read the proposal helps pick up places where I haven’t described something well enough for outsiders or where I am using terms that are too specific for a diverse audience.

Key things found by the outsiders who read my proposal:

1.  I start talking about “outcomes of interest” before I define the outcomes of interest leading to confusion for the reader.

2. I don’t have citations for all the concepts I am including which gives the study a weak foundation.

3. I missed a major potion of the methods because in my mind it was obvious.

4. I left some possible outcomes on the table.  One of my readers made suggestions about additional data I may have access to which could strengthen the evidence from my study.

So keep this in mind both for your advocacy work, and for your grant writing…have some trusted advisers who are NOT a part of your project read what you write. I promise it only improves the project.



I’ll see you at the AWHONN Convention

Jun 10th, 2015 Conferences

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I leave for Long Beach, California later this week to attend the AWHONN Convention. If you are going and want to meet-up, send me a message on Facebook.

If you are not attending AWHONN, you can also see me at the ACNM Annual Meeting or the Lamaze Conference.



Childbirth Education Ap

Jun 8th, 2015 Best of the Web, Marketing, Working With Clients

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Have you seen the new Pregnancy to Parenting app from Lamaze International? Designed as an educational tool for expectant families, the app is also allowing families to interact with Lamaze educators.

Interesting concept.  If you are a Lamaze educator you can participate in training to learn how to use the app to interact with families.  I’ve been toying with the idea of teaching a few classes over the next few months while I work on my dissertation, so this new product might it easier to do that.


Shoulder Dystocia Education

Jun 6th, 2015 Education, Training

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Looking for some basic education on shoulder dystocia?  AWHONN has an Shoulder Dystocia Online Product which may fit your needs.



Midwifery Students as Volunteer Doulas

May 19th, 2015 Paths, Training

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The Journal of Midwifery and Women’s Health published an article about a program utilizing student nurse-midwives as volunteer doulas.  I’ve seen programs similar to this, using nursing students or midwifery students.  The program in the article combined the use of community doulas and midwifery students.

Having run a volunteer doula service myself I’m usually skeptical of the long term success of such a program. Being a volunteer is not the same as being paid (or getting class credit) for attending a birth. The volunteer has to feel as if the commitment benefits the women being served, and to some extent benefits the doula (or at least doesn’t disrupt life too much).

After the first birth or two it can be difficult to get volunteers to commit the time and effort needed for a busy service. Why? Because many volunteers do so because they think they want to be a doula, and after a birth or two they either decide it isn’t for them or they start their own practice.

You can make the commitment easier by scheduling on call days instead of assigning a doula or team to a woman, but there will be one or two volunteers who don’t get to be at a birth in the first few months and so feel as if the program offers them nothing to participate and neither the volunteer nor the women are benefiting because they are there. It’s tricky to work with volunteers.

This type of program has the benefit of using students – which means you have a regular supply of new, excited volunteers.  But that also means they will quickly become overwhelmed with a busy schedule and may not want to attend births as a volunteer after they start attending births as a student–a potential benefit of using student nurses instead of using student midwives.

Another benefit is that this  allows new midwives (and nurses) to learn about the doula role, and how to best work as a team at a birth.  I’ve also seen volunteer doula programs work well to get new doulas valuable experience as they learn to attend births.

What do you think about using students as volunteer doulas?  Do you have another way to bring volunteer doulas to your community?



  • Munoz EG, Collins M. Establishing a Volunteer Doula Program Within a Nurse-Midwifery Education Program: A Winning Situation for Both Clients and Students. J Midwifery Womens Health. 2015 May 7. PMID: 25953010.


Understanding Fear of Childbirth

May 18th, 2015 Research

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A study published in the June edition of Acta obstetricia et gynecologica Scandinavica explored fear of childbirth through maternal surveys.  While the study question was about the effect of counseling for fear of childbirth, several interesting things are revealed in the descriptive statistics (the part of the study where the researchers tell you about the individuals in the study). The authors report this counseling was generally from midwives either with or without specialized training in counseling, or from an obstetrician, and the counseling is never really described as an intervention.  For that reason we won’t dwell too much on the effects of the counseling.

Out of 936 women who completed questionnaires two months post-partum, 70 women reported having counseling due to childbirth fear. This is just over 7% of the women.  But when you break the women into those having their first delivery and those who gave birth before, you find only 6% of the women having their first delivery reported having counseling while 9.5% of the women who gave birth before.  I find this interesting because it runs counter to what I’ve been told about fear and childbirth.

I’ve been told that women fear childbirth because they don’t have experience with it anymore, and because the media portrays birth as something horrible.  But this data turns that around, women with personal experience giving birth were more likely to have fear so extreme they needed counseling.

If we keep exploring the data we learn something interesting about those multips.  Most of the women had normal vaginal births for the previous experience, as we might expect.  If the woman had any instrumental birth or an emergency cesarean, she was more likely to receive counseling. If the woman had an emergency cesarean her odds of having counseling for fear were 5 times higher than a woman who had a normal vaginal delivery. This effect did not exist with planned cesarean.

There are some problems with this study – a big one is that about 1/3 of the women who reported receiving counseling stated they had little or no fear of childbirth.  As far as I can tell, there was no adjustment for this in the analysis (which is another reason why we won’t think too much about their main outcome). If you want to know if counseling reduces fear, you need to start with a group who has fear.  If this had been my data, I would have only analyzed the 100 or so women who reported fear.  But the question for us to ponder now is might we see something different in terms of multip vs. nullip being more afraid if only those who reported fear were reported?



  • Larsson B1,2, Karlström A3, Rubertsson C1, Hildingsson I1,3,4. The effects of counseling on fear of childbirth. Acta Obstet Gynecol Scand. 2015 Jun;94(6):629-36. PMID: 25772528.


Advocate for Lactation

May 14th, 2015 Advocacy, Raising Awareness

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The Friendly Airports for Mothers (FAM) Act has been introduced into congress.  The Act, if made into law, would require airports to provide accessible, safe, clean, and convenient lactation rooms for travelers.

The United States Breastfeeding Committee needs your help. By sharing your airport lactation experience you will be providing valuable evidence to lawmakers about the importance of this issue.

If you are willing to contribute your story, visit the United States Breastfeeding Committee website and complete the submission form.


Be a Research Subject

May 13th, 2015 Research

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Here is an opportunity for you to participate in research that helps us understand what it is like to become a mother.  Researchers at the University of Michigan are investigating the pregnancy-related experiences that are unique to sexual minorities to help minimize the effect of these stressors on prenatal and postnatal outcomes.

If you are a lesbian couple, aged 18-45 and expecting your first child, they want to talk to you.  Here is a flier that provides general information:

Flyer (pdf)

And a few more specifics if it helps you decide:

For this study, we are recruiting lesbian couples ages 18 to 45 who are expecting their first child. If couples decide to participate, both partners will be asked to come to our laboratory between two and four times to complete questionnaires related to their thoughts, feelings, and behaviors concerning the transition to parenthood. Participants can also complete the sessions at home if they live outside of the Ann Arbor area In order to better understand physiological processes, we will also ask permission to collect saliva samples. All couples will be compensated monetarily for their participation in the study, up to $300 if they complete all sessions.

 Interested?  Contact the researchers here: Edelstein Lab


Balancing Family and Training

May 13th, 2015 Jennifer's Training, Paths

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My semester has ended, which is good because so many things on the website have been neglected during this round of classes.  For those who are new to the blog, I’ve just completed my second year in a PhD Program in Nursing.  The second year is a bit more intense.  In addition to classes I have the expectation that I will have a grant submitted for my dissertation research and my dissertation proposal accepted this summer.  I’m progressing well on both fronts, so no worries.  But I wanted to share a few reflections for those who have not yet begun their training.

One of the reasons I frequently hear individuals putting off training in midwifery is the belief that balancing family and training will be easier once the children are older.  I believed this too, until this past year when I finished a year of school with two teenagers. I can honestly tell you it was not as easy as balancing nursing school with two elementary aged children.  Why?

In elementary school I set the schedule because the options for the children were limited.  They wanted to play with neighbors, attend the infrequent movie nights and activities in school, and the school band/orchestra only had two concerts per year.  The children in the church had activities during Sunday service times. My children did not hold leadership positions anywhere.

But now my children have their own goals because they are aware of more opportunities.  Scouting is no longer just one night a week, instead there are monthly camp-outs and extra meetings for the youth leaders.  Playing an instrument involves the district honor band with weekly rehearsal and three performances each year; or the marching band with multiple after school practices and weekend game performances.  The larger schools mean friends are not limited to the neighborhood, and hanging out with friends involves rides to malls, movies, or other venues. The church youth group meets one evening a week — and adds additional activities on weekends.

All of this means either I or my husband must drive my children somewhere almost every day.  To accomplish all the goals of all the people who live in this household, I must plan that my schooling is essentially a job with very specific hours of work.

Your family situation may be different, but it wouldn’t be fair if I didn’t mention that this seems to be the norm among the families I know with teen age children.  There is relief when one of the children begins to drive because the workload is distributed.

When my children were in elementary school I used to shake my head at the families that ate in the car on the way to softball practice; or would go from dance class straight to chess club in the evening. I used to think I could prevent my family from becoming that busy, but the reality is limiting it didn’t fit with who I was as a parent.  I want my children to set goals and try new things, to not be afraid of being committed to something. The difference is that when children are teenagers, that commitment to any group, organization, or team is a bigger time commitment than what it was in elementary school.


We have an early dinner together as a family 5-6 nights a week, and generally have only one place to go three to four nights a week. I know there are families that are busier, and other families do less. How your family balances it will depend on the number of children you have, differences in ages, and differences in their interests.

My point is, if you are putting off your training because you believe the logistics of being in school with a family is easier with teens, you might want to reconsider your assumptions.



Birth – hobby or work?

Feb 23rd, 2015 Paths

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I am in the process of trying to decide what role the website will have in my future life (let’s face it, 15 years is a long time to keep it going). As part of the process I’ve starting thinking about what it takes to make birth a job rather than a hobby.

To start with, I don’t think hobby’s are bad things.  I have a few I enjoy very much.  But hobbies are done for our pleasure, not to meet the needs of others.  Hobbies and jobs occupy different spaces in our lives, and demand different responsibilities. Jobs we do to earn money, again not a bad thing, and generally involve providing a service or product for others. Because a job is a way to generate income you have to think about the things you do differently. Continue reading


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