Here we are in the middle of summer in the Northern Hemisphere, but my sights are set on the fall and the Lamaze International 2016 Annual Conference scheduled October 20-23, 2016 in West Palm Beach, FL. This year's theme is "Lamaze Is..." and I am very much looking forward to both the plenary speakers and the variety of talented concurrent presenters that have been selected. Maybe you have already registered and maybe you are still on the fence about joining your colleagues at the conference. Between now and the conference, I will be offering Science & Sensibility readers interviews with our plenary speakers, to gain a little insight about their work and their planned conference presentation. I hope you enjoy learning more about these carefully chosen presenters and looking forward to seeing you at the conference where we can enjoy them together.

Our first interview is with Debby Amis, RN, LCCE, FACCE who will be presenting a "Research Update for Childbirth Educators" on Friday afternoon. Debby runs The Family Way with her business partner Jeanne Green. The Family Way publishes childbirth education materials and trains childbirth educators in a Lamaze approved seminar. - Sharon Muza, Science & Sensibility Community Manager.

Sharon Muza: Why is it important for childbirth educators to remain up-to-date on new research and trends in maternal infant health?

Debby Amis: Childbirth educators have a responsibility to make sure that what they are teaching is evidence-based. The only way to do to that is to keep up with the evidence. Also, in this day of "instant news," students expect their instructors to be up-to-date.

SM: What are some the best places for educators to access updated information when they may have limited time and limited budget?

DA: Science & Sensibility does an excellent job of covering new research and trends. Henci Goer's "Childbirth U"email newsletter and Rebecca Dekker's "Evidence-Based Birth" website provide valuable updates. I have Google alerts too for birth-related news. Facebook friends often alert me to new studies too (though I always check dates to see if a study really is new.) 

SM: What should educators be doing with the information, when they learn of new research that impacts maternity care?  How do we apply the information we learn in our classes and share with the families we work with?

DA: Educators should carefully evaluate new information. That is one reason why I like Science & Sensibility so much. Sharon Muza often gets trusted experts such as Penny Simkin or Judy Lothian to analyze and comment on a new study or publication. Getting information from a trusted source is helpful. Systematic reviews such as Cochrane Reviews carry a lot more weight than a single study. Press releases about a study often do not tell the whole (or even accurate) story. If I am particularly interested in a study, I will try to locate a copy of the actual study. Some European and Canadian journals offer free access, but sometimes it is a struggle to find a copy of a study. I would be willing to be an annual fee to a medical library to get access if anyone knows of a library that offers this service.

Class discussion and having class members investigate topics is effective. I also like providing written information to students in my classes (in the form of a class workbook or handout as a back-up to our discussions). It is important to me that I can back-up (with studies or guidelines from professional organizations) what I say. 

SM: Why is it important not to "cherry pick" research that is shared in childbirth classes?

DA: Ethics! Just as I would like health care providers to provide full information to their clients, I expect childbirth educators to present full (evidence-based) information to students in their classes. Students have the right (and responsibility) to make their own informed decisions. Also, we want to prepare students to communicate effectively with their health care providers. If we only present a one-sided view of a topic, our students may fall flat on their faces when communicating with their health care providers (and hearing for the first time other considerations). 

SM: What is your favorite source for new research?

DA: The Web! And as mentioned above, Science & Sensibility, Henci Goer's Childbirth U, Rebecca Dekker's Evidence-Based Birth website, and press releases about new studies (taken with a grain of salt). Systematic reviews are more helpful than single studies. I also periodically do PubMed searches topics such as epidurals, etc.

I am grateful to read the analysis of experts, such as Goer's and Romano's excellent book, Optimal Care in Childbirth. I just read Making Informed Decisions on Childbirth by Sofie Vantiers, which I really liked too. 

SM: What tips do you have for reading research studies - how can we learn how to read and understand them?

DA: This is hard to answer, because everyone has a different background, schooling, and experience. The more studies you read, the better you will get at reading them. You can google quite a few helpful articles on reading medical studies. For sure, look at the size of the study, who conducted the study (any potential conflicts of interest?), and how they interpreted the results. Would you draw the same conclusions? Have other researchers on the same topic found the same results? For example, most epidural studies are conducted by anesthesiologists. This makes sense because it is anesthesiologists who perform epidurals. But many studies compare epidurals to narcotics or one dose of an epidural to another dose of epidural. It is rare to find a study comparing epidural to non pharmacological pain management. Then there is the issue of crossover. It is not considered ethical to deny a woman an epidural if she wants one, so a woman randomized to a "no epidural" group may actually get an epidural. That muddies the results. So I don't think we have good data on the true side effects or risks of epidurals.

SM: How do we recognize good research vs bad research?

DA: See above. Plus sometimes a study is too small or underpowered to draw meaningful conclusions. Sometimes results are not significant, so you really shouldn't draw conclusions. Sometimes differences between groups in a RCT are not significant enough to draw conclusions. Unfortunately, there are many other factors that can make "bad" research.

SM: Give us a sneak peak at your upcoming presentation - what recent study do you think has had the most impact on maternal infant care practices?

DA: Not going to tell! After the conference, I will post a newsletter with the 2016 "Top Ten" on our website at www.thefamilyway.com for those who cannot make it to West Palm Beach. But I hope to see you there!

Published: July 12, 2016

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