If you have taken your journey to midwifery along a path that has you employed in a hospital, you are likely familiar with the Joint Commission.  If not, you need to know how this organization improves perinatal care. The Joint Commission is an organization that accredits hospitals for meeting certain benchmarks, they call these the core measures.  The idea is the core measures represent what is expected in an institution which provides high quality, evidence-based care. This accreditation is one of the most powerful bits of advocacy for high quality care in the US.  Why?Read More →

The problem with epidemiological associations is the wide variety of things which may be driving them.  For example, a new study  reports an association between hospital geographic location and the variation in primary cesarean delivery rates in the United States. This phenomena is not limited to the United States, a study published in the European Journal of Public Health reports evidence of local drivers of cesarean rates. How much do all these factors matter?  In the cesarean study, almost 40% of the variation in adjusted relative risk for primary cesarean — in plain terms, these factors mattered quite a bit. The question is, what are these local drivers?Read More →

No one really believes the Friedman Curve represents timing of cervical dilation anymore.   Modern researchers have used more sophisticated techniques to identify problems with the Friedman Curve, generally about the slope of the line which represents the speed or progress of dilation. What remains from the Friedman Curve is the idea that labor has a line that can represent the normal process of dilation. This line becomes the basis of judgement of normality of labor. In some places the labor progress is charted in a partograph to allow visual comparison of the progress to the line. Decisions to intervene are made based on deviation fromRead More →

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 forRead More →

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.Read More →

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 atRead More →

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 womenRead More →

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.Read More →