The Distinctive Needs of Military Families Surrounding Childbirth

Do you want to support military families?

Is your business near a military base?

Do you want to give something back to those who fight for our freedoms?

Then join us at the ICEA 2018 Conference for a specialized Concurrent Session: The Distinctive Needs of Military Families Surrounding Childbirth.

A newly expecting military family might be thousands of miles away from any close friends and/or family, they don’t have a typical support structure in place for this physically and emotionally momentous occasion.

The armed services do offer military families a vast amount of information on topics surrounding childbirth and there are some wonderful assistance programs to take advantage of. However, military families need more than just handouts, online reading, discount goods, and care packages. They need in-depth childbirth education series—they need educational support from the prenatal period through the first few, crucial months of being a new parent.

Listeners will understand the physical and emotional needs of newly expectant military couples and how they can offer childbirth education, doula services, and parenting preparation classes in support of these families’ distinctive needs.

The dual military couple, the Lieutenants Riffle, will be presenting this topic on Friday afternoon! LT Jimmie Riffle is an active duty Navy Nurse Corps officer and currently a DNP student at the Uniformed Services Health University in Bethesda, MD. Jimmie has been serving our great country for over 16 years boat side and bedside. Liz Riffle recently chose to leave active duty service in order to pursue more maternal/child management and consulting opportunities, as well as to start their own family very soon. Liz was an active duty Navy Nurse Corps officer for six years, and is currently still in the Reserves.

Register now to come dialogue with us regarding the opportunities surrounding this distinguished population on Friday afternoon at the conference!

Register Now

Take Advantage of our Special Student Rate

As a student in maternity health, you are the future of family-centered care. We want to invest in your future, so ICEA is now offering a special student daily rate of $100!

So grab some fellow students, hop in the car, and take a road trip to Louisville, Kentucky!

This conference will allow you to focus on the evidence-based information and research most relevant for birthing and breastfeeding practices, education, and support. Here are just six of the many reasons you should join us in Louisville, Kentucky, USA on 19-21 April:

  1. Learn from our incredible general session speakers including, Robbie Davis-Floyd, Rebecca Dekker, and Kathy Kendall-Tackett
  2. Attend our concurrent sessions and bring home new evidence-based information and skills
  3. Earn up to 75 contact hours approved by ANCC and IBCLC
  4. Celebrate Penny Simkin’s 80th birthday and her 50 years of faithful service to family-centered maternity and newborn care
  5. Network with other birth professionals from around the world
  6. Enjoy the unique city of Louisville

Visit our website to view full draft agenda. Make sure you don’t miss these informative sessions, and register by 9 April to take advantage of this special rate!

Register Now!

Last Day to Submit Your 2018 ICEA Award Nominations

I’ll bet you know someone who you have always thought should be recognized for their excellence and contributions to childbirth education, doula and/or breastfeeding work and support. Someone who exhibits the ICEA Core Values of Compassion, Collaboration and Choice.

Now is the time to shine a light on your exceptional colleague.

The ICEA board has reinvigorated our awards and you’ll want to be a part of this exciting celebration.

The nomination process begins now! And we want to hear about your amazing colleagues.

Please see the nomination details and mail your nominations to nominations@icea.org by March 16, 2018

The honorees will be announced at the Louisville, Kentucky Conference, April 19-21, 2018 during the General Sessions. Register now so you can be part of these exciting and inspirational honors.

Please nominate someone you know for the following awards:

The Circle C Award
A member who demonstrates the ICEA core values by approaching maternity care with:

  1. Compassion: nurturing spirit improves birth outcomes for all families.
  2. Collaboration: based on the knowledge that mindful engagement with diverse groups advances positive, family-centered maternity care. Examples would be with working collaboratively with broad and varied members in the workplace and health care setting, community and professional organizations.
  3. Choice: practicing and promoting a culture of freedom of choice by of empowering expectant families through informed decision-making. An example of this would be a member stepping outside of their personal values and encouraging informed choice through broader decision making.

Childbirth Educator 
For the ICEA certified childbirth educator who demonstrates excellence, enthusiasm and innovation.

Doula
For the ICEA certified doula who demonstrates excellence, enthusiasm and innovation.

Breastfeeding 
For the ICEA member who demonstrates excellence, enthusiasm and innovation in breastfeeding and support of the WHO code.

Sister Circle
For a public persona or figure who supports and promotes ICEA core values.

See you in Louisville,

Colleen Weeks LCCE, FACCE, CLE, CSE, RTS
ICEA Director of Marketing

Submit Your Nomination

What’s in the Future for Childbirth Education?

by Rebecca Dekker, PhD, RN, APRN

About a year ago, I decided that I wanted to work more closely with families in my home town of Lexington, Kentucky. So I developed a curriculum, and then scheduled independent childbirth classes in my hometown. I reached out to all the providers and doulas that I knew. I mailed flyers, posted flyers, and used social media to try and advertise my class. Even with my name recognition (Rebecca Dekker of Evidence Based Birth®), nobody signed up to take my 5-week childbirth class series. Which seemed odd to me. What was going on? Was it the fact that local hospitals offered free classes? Or was something else going on?

In 2013, the Listening to Mothers III survey found that only 1 in 3 mothers giving birth in U.S. hospitals that year had taken a childbirth class. And yet, these people are walking into a flawed health care system, where non-evidence based care is routine. They could use all the education and help they can get! Why aren’t they getting educated by a certified childbirth educator?

A few years ago, one of my mentors gave me advice when I was struggling with an issue in terms of how I could best serve my audience. She said, “Stop trying to guess what people are thinking. Ask them!” “Ah. You’re right!” I answered! “Why didn’t I think of that before?” Ever since that time, my policy is to ASK people what they want at Evidence Based Birth®, before I create anything!

So, I decided to hold a couple of online focus groups to find out what was happening. I sent out an invitation, specifically looking for people in their twenties, who were either pregnant, recently had a baby, or were planning on having a baby in the next five years. We had a great group of about 18 people in their twenties who video-chatted with me and told me their thoughts about childbirth. Another 34 people, who couldn’t make it, let me know their thoughts by email.

I’m not going to reveal all of their answers—I’m saving the bulk of what I found for the ICEA conference—but here 3 of the 9 themes that I found:

  • I can learn everything I need to know from the internet or from watching YouTube videos
  • I plan on just showing up and having the doctor and nurses tell me what to do
  • I’m too busy—I don’t have the time or money, and I don’t want to leave my home

Basically, what they told me, is that today’s young people would much, much rather stay at home in their fuzzy slippers than attend a live, in-person class. I totally understand—I’m exhausted at the end of the day, too! I can also see why casual online learning is so much more appealing young people. And yet… most online courses have DISMAL completion rates. Planning to offer a completely online childbirth class? Chances are only 5% of people who sign up will actually watch every video and complete the entire class.

So, what’s the solution? How do we reach today’s generation of birthing people? How do we entice them to leave their homes? Should we be making changes to how we teach? If so, what kind of changes should we be making?

And even if we do somehow figure out a way to get people to our classes, how do we handle the dilemma that nearly every childbirth educator I meet struggles with? That dilemma is, how do you help them get evidence based care, when evidence based care is extremely difficult to get in your community? For example, what if you teach childbirth classes at a hospital, and you encourage your clients to move around as much as possible during labor? But in the back of your mind, you know that once they arrive, they’ll most likely be hooked up to a continuous electronic fetal monitor that restricts their movement? What if you are encouraging your students to use a tub during labor, and they’re SO excited about that, but in the back of your mind you know that there’s only one room with a tub, and the nurses aren’t likely to fill it up?

Basically, I see the future of childbirth education as facing two critical issues:

  1. How do we get millennials into our childbirth classes?
    and
  2. How do we help millennials get evidence based care, when it isn’t the norm?

I’ve spent the past few months brainstorming solutions to the first problem, and the past five years brainstorming solutions to the second problem. After talking with parents and educators from across the country, I’m excited to share some potential solutions with you.

To learn about those potential solutions, make sure you register for the 2018 ICEA Conference in Louisville, Kentucky. When you arrive, make sure you come to my session about “Childbirth Education and Birth Plans” to hear my solutions for the future of childbirth educators. Also, feel free to stop by my booth afterwards for photo ops and to chat some more!  I can’t wait to meet many of you in person.

See you soon!

Epigenetics and Breastfeeding

Source: United States Breastfeeding Committee

by Cynthia Billiar BSN, RN, IBCLC, ICCE, ICD, ANLC

Research suggests that we carry genetic memories of our ancestors that can affect our health. These genetic memories are called epigenetic tags. Epigenetics literally means on top of the gene, (Wilson, n.d.). Epigenetics encompass all the processes that lead to inherited changes in gene expression during development and across generations, (Epigenetics, n.d.).

Animal research shows that some epigenetic tags are passed through up to 10 generations out. During the Dutch Hunger Winter in 1944-1945 people suffered very difficult conditions, including stress and hunger. Researchers have been able to study the human epigenetic tags of the subsequent generations of the survivors of the Dutch Hunger Winter up to 60 years later. They found that the babies born to these survivors and several generations forward were more likely to have heart disease, diabetes, obesity and a wide variety of brain related conditions such as bipolar disease and schizophrenia, (Wilson, n.d.).   Another study reported that descendants of the people who survived the Holocaust have different stress hormone profiles than that of their peers, possibly predisposing them to anxiety disorders, (Rodriquez, 2015).

The genetic information we inherit from our parents is called the genome, it is the complete assembly of our DNA. The epigenome is a multitude of chemical compounds that attach to the genome/DNA and modify its function, in other words, turning genes on or off; when this change happens, it is said to have “marked” the genome. This does not change the sequence of the DNA but it changes the way cells use the DNA’s instructions, (Epigenomics, 2016).  The epigenome can be altered by environmental and lifestyle factors such as nutrition, chemicals, stress, and emotional experiences. Although our epigenome can potentially be altered throughout our lifetime, from in utero to age three is the most critical period of development in terms of the epigenome in humans. This is the time that our DNA is most receptive to epigenetic changes and alters the way our organs and predisposition to certain diseases develop. Maternal environment during pregnancy and the infant’s first received nutrition impacts the epigenome significantly, (Wilson, n.d.). Breastmilk can potentially change the epigenome to affect the lifelong health of the infant, (Wilson, n.d.).  Just because you may carry a gene that is known to be associated with a disease does not mean it will ever develop, (Tow, 2014).

We have extensive evidence that those of us who have been breastfed or received breastmilk show lower risks of developing some non-communicable diseases. We know that breastfeeding can decrease the risk of developing type 1 diabetes and childhood cancers in children who are genetically susceptible to these diseases. We know that breastfed children born to families that are susceptible to cow’s milk allergies, if given just one bottle of infant formula, can become sensitized, (Walker, 2014). There are many components in human milk that can change gene expression and can decrease diseases such as childhood obesity, immune disorders, liver disease, and cholesterol issues, (Wilson, n.d.). Breastfeeding also benefits the mother, as we know it can decrease breast cancer, ovarian cancer and osteoporosis later in life.

We cannot begin to know all of the epigenetic tags we carry or pass on from our ancestors that can affect our health and the health of future generations. We can however, make a difference with what we do know, and that is our choices do affect others.  Remember that nutrition plays a key role in whether some of those epigenetic tags from our ancestors are turned off or on. Keep in mind that from in utero to age three is the most critical period of development in terms of the epigenome in humans, and that breastmilk can potentially change the epigenome to affect the lifelong health of a child. Take care of yourself because we now know what you do today can affect not only your health but the health of many generations to come.

References
Epigenetics: fundamentals. (n.d.). Retrieved from https://www.whatisepigenetics.com/fundamentals/
Epigenomics. (2016). Retrieved from https://www.genome.gov/27532724/epigenomics-fact-sheet/
Rodriquez, T. (2015, March 1). Descendants of the holocaust survivors have altered stress hormones. Scientific American. https://doi.org/https://www.scientificamerican.com/article/descendants-of-holocaust-survivors-have-altered-stress-hormones/
Tow, J. (2014, march). Heal the mother heal the baby epigenetics breastfeeding and the human microbiome. Breastfeeding Review, 22(1), 7-9. https://doi.org/https://www.researchgate.net/publication/262145446_Commentary_Heal_the_mother_heal_the_baby_Epigenetics_breastfeeding_and_the_human_microbiome
Walker, M. (2014). Supplementation of the breastfed baby Just one bottle won’t hurt—or will it. Retrieved from https://massbreastfeeding.org/wp-content/uploads/2013/05/Just-One-Bottle-2014.pdf
Wilson, L. (n.d.). Nutrition and breastfeeding – the long-term impact of breastmilk on health. Retrieved from http://motherjourney.com/uploads/3/5/3/1/35315324/epigenetics_and_breastfeeding_article.pdf

Circle Around the ICEA Awards

I’ll bet you know someone who you have always thought should be recognized for their excellence and contributions to childbirth education, doula and/or breastfeeding work and support. Someone who exhibits the ICEA Core Values of Compassion, Collaboration and Choice.

Now is the time to shine a light on your exceptional colleague.

The ICEA board has reinvigorated our awards and you’ll want to be a part of this exciting celebration.

The nomination process begins now! And we want to hear about your amazing colleagues.

Please see the nomination details and mail your nominations to nominations@icea.org by March 16, 2018

The honorees will be announced at the Louisville, Kentucky Conference, April 19-21, 2018 during the General Sessions. Register now so you can be part of these exciting and inspirational honors.

Please nominate someone you know for the following awards:

The Circle C Award
A member who demonstrates the ICEA core values by approaching maternity care with:

  1. Compassion: nurturing spirit improves birth outcomes for all families.
  2. Collaboration: based on the knowledge that mindful engagement with diverse groups advances positive, family-centered maternity care. Examples would be with working collaboratively with broad and varied members in the workplace and health care setting, community and professional organizations.
  3. Choice: practicing and promoting a culture of freedom of choice by of empowering expectant families through informed decision-making. An example of this would be a member stepping outside of their personal values and encouraging informed choice through broader decision making.

Childbirth Educator
For the ICEA certified childbirth educator who demonstrates excellence, enthusiasm and innovation.

Doula
For the ICEA certified doula who demonstrates excellence, enthusiasm and innovation.

Breastfeeding
For the ICEA member who demonstrates excellence, enthusiasm and innovation in breastfeeding and support of the WHO code.

Sister Circle
For a public persona or figure who supports and promotes ICEA core values.

See you in Louisville,

Colleen Weeks LCCE, FACCE, CLE, CSE, RTS
ICEA Director of Marketing

Submit Your Nomination

The “Fourth Trimester”

by Donna Walls RN, BSN, ICCE, IBCLC

The initial transition to motherhood is unique for every mother/baby dyad. It is a time of exploration, nurturing, learning and falling in love. This transition time is celebrated and supported with very different traditions around the world.

An overriding philosophy in most western cultures has changed from what was viewed as the “lying in period” of rest for 3-4 weeks post birth to the present concept of encouraging self-care when the mother focuses on restoring her health to be able to care for herself, her newborn, and her family as quickly as possible.

In many other cultures, the emphasis is on a prescribed period of time focusing on rest and recovery while friends and family care for the mother and often her family and home. The mother’s only responsibility is caring for her infant. In China, the postpartum time literally means “sitting the month” when new mothers are served nourishing foods aimed at restoring health and supporting lactation. In Korea, the resting period post birth is commonly referred to as “the 100 days of birth” while in Japan the “ansei” means “peace and quiet with pampering” for the first three weeks.

In India, the “confinement” lasts from 40-60 days and includes herbal baths and massages. In Africa, new mothers remain quietly at home for 10-40 days, and in some African countries it can be up to three months with friends and family taking care of her home and other children

In Mexico, “la cuarentena,” translates to “quarantine” and continues for forty days which some studies have shown to encourage infant and mother bonding.

In Holland, a “kraamverzorgster,” a qualified healthcare professional, provides care at home to mother and baby during the first eight to 10 days post birth and is a mandatory part of maternity care. These women are generally in the home for 5-6 hours a day and provide physical, emotional, and breastfeeding support, much like the role of the postpartum doula in the United States.

In the United States, new mothers often face returning to work or school within 2-4 weeks after giving birth. This early transition time can be challenging with altered sleep patterns, uncertainties of the new maternal role acquisition, and changing relationships with spouse and other family members. Early return to previous job or school schedules can exaggerate anxieties or concerns common in this timeframe.

There are conflicting opinions on which care tradition seems to be the most advantageous. Is extended rest harmful, leading to complications? Or, is early return to physical activities resulting in increased risk of complications? Unfortunately, there is little research on this topic

The postpartum period associated with healing and physical return to the non-pregnant state is generally recognized as six weeks. This time period allows for uterine involution, establishment of lactation, and adjustment to the role of mother.

Women have always sought other women, both family and friends, for guidance and support. This tradition of passing along knowledge and wisdom regarding infant care, emotional changes, physical expectations, breastfeeding support, and sexuality can become difficult when women are geographically separated from female family members or close social support.

Resources
Postpartum Maternal Health Care in the United States: A Critical Review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595301/
Factors Associated with Postpartum Maternal Functioning in Women with Positive Screens for Depression.Barkin JL, Wisner KL, Bromberger JT, Beach SR, Wisniewski SR. J Womens Health (Larchmt). 2016 Jul; 25(7):707-13. Epub 2015 Nov 24.
The inadequacies in postnatal health care – ScienceDirect
http://www.sciencedirect.com/science/article/pii/S2352081716301623 by N Fogel – ‎2017
Systematic review of the literature on postpartum care: effectiveness of postpartum support to improve maternal parenting, mental health, quality of life, and physical health.
Shaw E, Levitt C, Wong S, Kaczorowski J; McMaster University Postpartum Research Group.
Birth. 2006 Sep;33(3):210-20
Pregnancy as an ideal time for intervention to address the complex needs of black and minority ethnic women: views of British midwives.Aquino MR, Edge D, Smith DM.
Midwifery. 2015 Mar;31(3):373-9. doi: 10.1016/j.midw.2014.11.006. Epub 2014 Nov 13.
Understanding and meeting the needs of women in the postpartum period: the Perinatal Maternal Health Promotion Model. Fahey JO, Shenassa E. J Midwifery Womens Health. 2013 Nov-Dec;58(6):613-21. doi: 10.1111/jmwh.12139. Epub 2013 Dec 9. PMID:24320095
Social support during the postpartum period: mothers’ views on needs, expectations, and mobilization of support. Negron R, Martin A, Almog M, Balbierz A, Howell EA.
Matern Child Health J. 2013 May;17(4):616-23. doi: 10.1007/s10995-012-1037-4.PMID:22581378
The role of maternal self-care in new motherhood. Barkin JL, Wisner KL.Midwifery. 2013 Sep;29(9):1050-5. doi: 10.1016/j.midw.2012.10.001. Epub 2013 Feb 15. PMID:23415369