One of the valuable benefits for Lamaze International members is a subscription to Lamaze International's official journal - The Journal of Perinatal Childbirth Education (JPE), whose mission is to promote, support, and protect natural, safe, and healthy birth through education and advocacy. The journal publishes peer-reviewed articles and evidence-based, practical resources that childbirth educators and other health care professionals can use to enhance the quality and effectiveness of their care or teaching to prepare expectant parents for birth.

Through evidence-based articles, the JPE advances the knowledge of aspiring and seasoned educators in any setting-independent or private practice, community, hospital, nursing or midwifery school-and informs educators and other health care professionals on research that will improve their practice and their efforts to support natural, safe, and healthy birth.

The JPE also publishes features that provide practical resources and advice health care professionals can use to enhance the quality and effectiveness of their care or teaching to prepare expectant parents for birth. The journal's content focuses on pregnancy, childbirth, the postpartum period, breastfeeding, neonatal care, early parenting, and young family development. In addition to childbirth educators, the JPE's readers include nurses, midwives, physicians, and other professionals involved with perinatal education and maternal-child health care.

Consider joining Lamaze International to receive this member benefit along with other perks. There is value and benefit to all birth professionals. This quarter's publication is, as usual, chock full of useful information. Here are the abstracts for your review:

Early Postpartum Support in the Home: A Vital Link to Healthy and Safe Postpartum Recovery in the United States

Author: Graves, Jodi, Birth & Postpartum Doula, BS, MS Nutrition

Abstract: Many newly postpartum women and birthing people are sent home from the hospital with their newborn babies, ill-prepared to care for themselves with little to no capacity to learn about newborn care and parenting. Women are often left to fend for themselves in the “black hole” of health care in 6 weeks post-birth that the United States calls postpartum care. Postpartum doulas can be the first line of defense, helping people identify potential postpartum physical and mental health issues, and in many places, they are doing it on the front lines and in the homes of newly postpartum women and families. In this guest opinion piece, the author discusses her personal experience with birth and how it led her to become an advocate for postpartum doulas.

Access, Interest, and Barriers to Incorporation of Birth Doula Care in the United States

Authors: Mitchell, Amanda W., MPH, Sparks, Joshua R., PhD, Beyl, Robbie A., PhD,  Altazan, Abby D., MS, Barlow, S. Ariel, BS, Redman, Leanne M., PhD.

Abstract: Doula care improves maternal care, yet barriers exist to incorporating doula care. The purpose of this study was to evaluate interest and barriers to doula care. Overall, 508 women, 26–35 years of age (54.5%), White/Caucasian (89.8%), and married (88.6%), completed this study. Most reported ≥1 previous birth (97.6%). Respondents would “feel comfortable” (73.2%) and “more confident” (54.9%) with doula care at birth, and 57.9% reported their provider would be supportive of doula care. Only 39.0% expressed benefits to doula care during pregnancy compared to 72.6% at birth and 68.1% during postpartum. Most would hire a doula if health insurance covered some of the costs. Despite the recognized benefits and support of doula care, cost-associated barriers exist to the incorporation of doula care.

In This Issue: Perinatal Education in a Post-COVID World

Author: Budin, Wendy C., PhD, RN-BC, LCCE, FACCE, FAAN

In this column, the editor of The Journal of Perinatal Education discusses how the world has changed since the beginning of the COVID-19 pandemic and the lasting impact it has had on how we provide perinatal education. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote, support, and protect natural, safe, and healthy birth and postpartum.

COVID-19 Impact on Group Prenatal Education: A Comparison of Virtual and In-Person Formats

Authors: Ahlers-Schmidt, Carolyn R., PhD, Hervey, Ashley M., MEd

Abstract: This retrospective study compared knowledge, intention, and satisfaction outcomes between pregnant women who attended prenatal education in person (n = 202; 55%) prior to the COVID-19 pandemic or virtually (n = 166; 45%) during the pandemic. Results identified increases in knowledge and intention for a healthy pregnancy and safe infant care for both groups. Virtual participants were less likely to endorse developing a birth plan (p = 0.035), knowledge of breastfeeding resources (p = 0.006), confidence in the ability to breastfeed (p = 0.033), and plans to use only a safe infant sleep location (p = 0.045). Important education was provided by continuing Baby Talk during the pandemic. However, topics with activities/demonstrations during in-person learning that were discontinued for virtual learning had significantly lower increases for virtual participants. Virtual education should incorporate more demonstrations/activities.

Immersive Videos Improve Student Self-Efficacy in Clinical Lactation

Authors: Singletary, Nicola, PhD, MAT, IBCLC, Sanchez, Rebecca, PhD, Spencer, Dan, PhD, Fogleman, April, Danielle, PhD, RD, IBCLC, Chetwynd, Ellen, PhD, MPH, BSN, IBCLC

Abstract: The current study examined the use of immersive technology as a way to improve access to high-quality interpersonal breastfeeding interactions in an undergraduate clinical lactation course. In particular, we investigated the impact of immersive consultation videos and related activities on student self-efficacy, motivational beliefs, and perceived skill level. Results indicate that usability was high, with participants rating videos, interactives, and activities positively. Students did report a significant increase in self-efficacy and their perceived ability to meet the course learning objectives; no significant changes in the level of interest or perceived skill were found. Our results demonstrate that high-quality immersive videos can be an important learning tool for teaching clinical skills when access to direct patient care is limited or absent.

Not Just Mechanical Birthing Bodies: Birthing Consciousness and Birth Reflexes

Authors: Dahan, Orli, PhD, Odent, Michel, MD

Abstract: There are two concepts of neuroendocrine reflexes associated with the expulsion of the fetus through the birth canal during the second stage of birth: the Ferguson reflex and the fetus ejection reflex. These concepts are often confused with one another and treated synonymously, thus interchangeable. However, the two not only refer to different phenomena, but they also represent the birthing woman differently. The Ferguson reflex treats the birthing woman as simply a biomechanical body. In contrast, the fetus ejection reflex does not ignore women’s conscious states during birth and recognizes what is currently a well-known empirical fact: The event of birth is a complex biophysical process affected by many mental, social, and environmental factors. In that, it has a connection to the phenomenon of birthing consciousness, which is the positive altered state sometimes experienced during a physiological and undisturbed childbirth. We argue that birthing consciousness and the fetus ejection reflex, made possible by reduced cortical control, are extremely helpful in promoting physiological human childbirth. Therefore, treating a woman giving birth as a biomechanical body is not only erroneous but can also lead to medical mismanagement of the second stage of physiological childbirth with associated mental and physiological consequences.

Vlogging Pregnancy and Laboring During the Pandemic on YouTube

Authors: Dai, Zehui, PhD, Meindl, Michael, MFA, Tetteh, Dinah, PhD

Abstract: Since early 2020, the world has been dealing with the COVID-19 pandemic. The rapid changing situation led to unforeseeable challenges and questions for many people, including pregnant women. Through a textual analysis of personal narratives told via pregnancy and/or laboring vlogs during COVID-19, this present study aims to understand how women from China who live in another country during pregnancy have utilized YouTube vlogs to share their experiences. Through this analysis, we identify various challenges that these women experienced during their pregnancy. The COVID-19 pandemic exaggerated the normal difficulties of these issues and also created additional problems for these women, including regular pregnancy tests, choice of birthing locations, and the support and caring that were normal during this time period.

A Pilot Study of an Educational Intervention to Increase Postpartum Medical Visit Attendance in Home-Visited Mothers

Authors: Cluxton-Keller, Fallon, MA, PhD, Bruce, Martha L., MPH, PhD

Abstract: Socioeconomically disadvantaged women experience barriers to attending postpartum medical visits (PMV). This three-phase pilot study explored the feasibility, acceptability, and preliminary effectiveness of an educational intervention to increase PMV attendance in mothers enrolled in early childhood home visiting. Phases 1 and 2 occurred prior to the COVID-19 pandemic, and Phase 3 occurred during the pandemic. Home visitor implementation of the intervention with mothers was feasible and acceptable in all phases. All mothers who received the intervention reported PMV attendance. Overall, 81% of mothers reported they discussed all questions with healthcare providers at the PMV. These findings provide preliminary effectiveness for a brief educational intervention in increasing PMV attendance in home-visited mothers.

Research Update: Healthy Birth Practice #1—Let Labor Begin on Its Own

Author: Amis, Debby, RN (Retired), BSN, CD (DONA), LCCE, FACCE

Abstract:This article is an adaptation for print of Debby Amis’s presentation at the 2022 Lamaze Virtual Conference. She discusses worldwide recommendations as to the optimal time for routine labor induction for low-risk pregnant persons, the recent research about the optimal time for routine labor induction, and recommendations to help the pregnant family make an informed decision about routine induction. This article includes an important new study not included in the Lamaze Virtual Conference that found an increase in perinatal deaths for low-risk pregnancies that were induced at 39 weeks as compared to low-risk pregnancies not induced at 39 weeks but were delivered no later than 42 weeks.

Outcomes of Childbirth Education for Women With Pregnancy Complications

Authors: Vanderlaan, Jennifer, PhD, MPH, CNM, Gatlin, Tricia, PhD, RN, CNE, Shen, Jay, PhD

Abstract: The purpose of this study was to examine associations between pregnancy outcomes and childbirth education, identifying any outcomes moderated by pregnancy complications. This was a secondary analysis of the Pregnancy Risk Assessment Monitoring System, Phase 8 data for four states. Logistic regression models compared outcomes with childbirth education for three subgroups: women with no pregnancy complications, women with gestational diabetes, and women with gestational hypertension. Women with pregnancy complications do not receive the same benefit from attending childbirth education as women with no pregnancy complications. Women with gestational diabetes who attended childbirth education were more likely to have a cesarean birth. The childbirth education curriculum may need to be altered to provide maximum benefits for women with pregnancy complications.

Published: October 18, 2023

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