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Fw: e-CIMS News: Coalition for Improving Maternity Services Newsletter

Posted Oct 28 2010 11:11pm
Sent: Tuesday, October 19, 2010 5:04 PM
Subject: e-CIMS News: Coalition for Improving Maternity Services Newsletter

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Denna L. Suko, MA
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Raleigh, NC  27607

Tel 1: 888-282-CIMS
Tel 2: 919-863-9482
Fax: 919-787-4916
e-CIMS News October 19, 2010
In this edition...
"One Voice" Letter to ACOG Gains Widespread Support
Reframing Birth and Breastfeeding: Moving Forward
CIMS Announces Mother-Friendly Nurse Recognition
Research Roundup!... Breastfeeding, episiotomy, induction of labor and more!
Education Spotlight... Upcoming Webinars, conferences, workshops and more!
For Expectant Families: Video Clips and print materials to help you have a better birth
"One Voice" Letter to ACOG Gains Widespread Support
Have you signed on yet?

It's not too late to add your name or your organization's name to our "One Voice" letter to Dr. Richard Waldman , president of the American College of Obstetricians and Gynecologists (ACOG).

More than 550 co-signing individuals and organizations have already joined CIMS in urging ACOG to remove additional barriers to VBAC (vaginal birth after cesarean). This request follows the March 2010 National Institutes of Health (NIH) Consensus Statement on VBAC , which found that VBAC is a reasonable choice for the majority of affected women. Specifically, we're urging ACOG to revise its current recommendation that VBACs should take place in hospitals where emergency cesareans are "immediately available," which the NIH concluded was not based on strong support from high-quality evidence and had influenced about one-third of hospitals and one-half of physicians to stop providing care for women who wanted to plan a VBAC. For additional information and resources, visit the CIMS website .

Add your name or your organization's name now . CIMS will collect the names of additional organizations and individuals in support of this request through October 31, 2010, and will send the updated list of co-signers to Dr. Waldman.

SHARE THIS!... A wonderful new VBAC resource for expectant families, " A Woman's Guide to VBAC - Navigating the NIH Consensus Recommendations " is available on the Lamaze International Giving Birth with Confidence blog.
"Reframing Birth and Breastfeeding: Moving Forward"
Join us March 11-12, 2011, in Chapel Hill, NC, for this collaborative event!

For nearly a decade, the CIMS Annual Mother-Friendly Childbirth Forum has been recognized for offering the most authoritative and up-to-date research information pertaining to the Ten Steps of Mother-Friendly maternity care. For our 2011 conference, we've teamed up with UNCG's Center for Women's Health and Wellness and UNC's Carolina Global Breastfeeding Institute who for five years have presented their " Breastfeeding and Feminism Symposium ," an exploration of opportunities to reposition breastfeeding as a valued part of women's (re)productive lives and rights.

This collaborative event, " Reframing Birth and Breastfeeding: Moving Forward ," will be held March 11-12, 2011, at the Sheraton Hotel in Chapel Hill, NC.

Confirmed speakers include
  • Eugene Declercq, PhD, MBA , Assistant Dean for Doctoral Education at Boston University School of Public Health, providing an update on national advances in improving maternity care.
  • Susan M. Ludington, PhD, CNM, FAAN , Professor of Pediatric Nursing, Frances Payne Bolton School of Nursing at Case Western University, presenting "Kangaroo Care for All and All for Kangaroo Care".
  • Miriam H. Labbock, MD, MPH, FACPM, IBCLC, FABM , Director of the Carolina Global Breastfeeding Institute, and Professor, Department of Maternal and Child Health at University of North Carolina at Chapel Hill
  • Bettina Lauf Forbes, Co-founder and President of Best for Babes , in "Beating the Breastfeeding Booby Traps" will explore the cultural & institutional barriers that prevent moms from achieving their personal breastfeeding goals.
  • Geradine Simkins, CNM, MSN , President and Interim Executive Director at Midwives Alliance of North America, presenting "What Really Matters: Using Midwives' Stories for Social Change".
  • Robbie E. Davis-Floyd, PhD , Fellow, Society for Applied Anthropology, and Senior Research Fellow, Department of Anthropology at University of Texas Austin, presenting "The International MotherBaby Childbirth Initiative (IMBCI): Current Implementation Projects and Preliminary Results".
Additional hot topics to be covered:

Don't miss these pre-conference workshops on Thursday, March 10:

Watch the CIMS website for additional program details as they are announced. 
Are You Mother-Friendly?
We envision a day when all families have access to Mother-Friendly Care.

Its takes serious commitment and much courage to provide Mother-Friendly Care within the context of our current health system, and CIMS believes that the time is long overdue for individuals that provide exemplary care to get the recognition they deserve. That's why CIMS developed Mother-Friendly Nurse Recognition--a personal and public recognition of individuals providing Mother-Friendly Care, an evidence-based model that is shown to improve the health outcomes of birthing women and their babies. Get the recognition you deserve !
"It's clearer than ever that how we give birth matters," stated Holly Powell Kennedy, PhD, CNM, FACNM, FAAN, president of the American College of Nurse-Midwives.  "The CIMS Mother-Friendly Nurse Recognition program celebrates the important role that nurses have in helping to ensure that mothers and infants receive evidence-based care, and recognizes that each of us has the power to make a difference."

Are you interested in supporting this program as a Local Liaison?  Local Liaisons facilitate and support nurses in becoming recognized as Mother-Friendly. Activities might include meeting with your local hospital administrators and/or nurse managers, distributing brochures about the program to local birth facilities and individual nurses, facilitating group discussions of the MFCI and the CIMS Evidence Basis for Mother-Friendly CareEmail us for additional details.

Research Roundup!
Breastfeeding, episiotomy, induction of labor and more! 

Breastfeeding Reduces Risk for Fever after Immunization
A prospective cohort study conducted at a pediatric vaccination center in Naples, Italy, set out to evaluate the effects of breastfeeding on the risk for fever after routine immunizations. The conclusion of the study suggests that the immune response to some vaccines is different among breastfed infants. Compared to infants who were not breastfed, infants who were exclusively breastfed had a reduced risk for fever following routine immunization by more than 50% even when several potential confounding factors were considered. The study, " Breastfeeding and Risk for Fever after Immunization ," by A. Piscane, et al, was published online May 2010 in the journal Pediatrics and is available as a free download.

Prolonged and Exclusive Breastfeeding Reduces the Risk of Infectious Diseases in Infancy
Researchers in the Netherlands examined the associations of duration of exclusive breastfeeding with infections in the upper respiratory (URTI), lower respiratory (LRTI), and gastrointestinal tracts (GI) in infancy. The study found that exclusive breastfeeding in the first four months and partial breastfeeding thereafter significantly reduced respiratory and gastrointestinal morbidity in infants. The study, " Prolonged and Exclusive Breastfeeding Reduces the Risk of Infectious Diseases in Infancy " by Duijts et al, was published in the journal Pediatrics.

New Federal Law Mandates Break Time for Nursing Mothers
The Patient Protection and Affordable Care Act ("PPACA"), which took effect when the PPACA was signed into law on March 23, 2010 (P.L. 111-148), amended Section 7 of the Fair Labor Standards Act (FLSA) to require employers to provide break times for nursing mothers. Employers must provide a place other than a bathroom, shielded from view, and free from intrusions from coworkers and the public for mothers to express breast milk. Mothers have the right to express breast milk as often as needed for the duration of one year. For more information, see Fact Sheet #73: Break Time for Nursing Mothers under the FLSA .

Increasing Obstetrical Interventions Linked to Increase in Singleton Preterm Birth Rates
When researchers examined the relationship between obstetrical intervention and preterm birth in the U.S. between 1991 and 2006 they found that the percentage of singleton preterm births had increased 13%. The cesarean delivery rate for singleton preterm births increased 47%, and the rate of induced labor doubled. The study authors (MacDorman, M., Declercq, E. and Zhang, J.) estimated that 42% of singleton preterm infants were delivered via induction or cesarean birth without spontaneous onset of labor and urge the public health community to play a central role in reducing unnecessary interventions.

SHARE THIS!... " Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestation ," developed by the March of Dimes, the California Maternal Quality Care Collaborative and the California Department of Public Health; Maternal Child and Adolescent Health Division, is a new Quality Improvement Toolkit designed specifically to provide "guidance and support to obstetrical providers, clinical staff, hospitals, and healthcare organizations to develop efficient and successful quality improvement programs to eliminate elective deliveries <39 weeks gestation."

Interventions Result in Longer Labor
Consistent with the mission of the MFCI in promoting wellness while reducing costs is a study in the September 2010 Obstetrics & Gynecology by Sarah Osmundson, MD et al titled " Elective Induction Compared With Expectant Management in Nulliparous Women With a Favorable Cervix ." The authors concluded that for first-time mothers with a favorable cervix for induction, the cesarean rate was comparable to first-time mothers who were expectantly managed. However with induction the labor was longer and required more interventions. This resulted in a longer hospital stay and use of healthcare resources with no compelling evidence that induction improved outcomes for mothers or babies.

Inductions Increase Second Stage Labor Complications, Risks for Women
In the September 2010 Obstetrics & Gynecology, a study titled " Comparing the Second Stage in Induced and Spontaneous Labor ," by Vanitha Janakiraman, MD et al, looked at the duration of labor and rate of complications in both groups. Although women who were induced and had previously given birth did not have an increased risk of maternal or fetal complications during the second stage, women induced in their first pregnancy were found to have an increased risk of cesarean and postpartum hemorrhage when compared to primiparous women who had a spontaneous labor. Because the MFCI encourages disclosure of interventions and outcomes in informed decision-making, CIMS agrees that "as rates of induction continue to rise, this information may be useful to physicians who counsel and manage patients in the second stage of labor", as stated by the authors of the study.

SHARE THIS!... From the Agency for Healthcare Research and Quality, " Thinking About Inducing Your Labor? A Guide for Pregnant Women " helps women make an informed decision about elective induction.

Fewer Women Face Trauma of Episiotomy
The MFCI discourages practices and procedures that are unsupported by scientific evidence, including episiotomies. Progress has been made in reducing the use of episiotomy in hospital births as concluded by authors Sallie S. Oliphant, MD et al in a report published in the October 2010 issue of Obstetrics & Gynecology. The study found episiotomy rates have decreased by more than 75% from 1979 to 2006 in the article titled " Trends Over Time With Commonly Performed Obstetric and Gynecologic Inpatient Procedures ." The decrease in rates of episiotomy may reflect obstetrical practice changes attributable to the recognition of increased trauma to the perineum with routine episiotomy use reported in the literature during that period of time.
Education Spotlight
Upcoming Webinars, conferences, workshops and more! 

SHARE THIS!... " Evidence-Based Practice: Pearls of Midwifery ," a new resource from the American College of Nurse-Midwives, showcases the benefits of midwifery practices that support labor and childbirth for mothers and babies. Because of its simplicity, it can be used with multiple audiences, such as hospital administrators, physicians, students, and consumers.

Childbirth Connection Webinars
CIMS has joined Childbirth Connection's Transforming Maternity Care Partnership focused on Blueprint Implementation. Upcoming Childbirth Connection Webinars highlight TMC Project topics.
  • Tuesday, Nov. 2 @ 12 noon (Eastern): "TMC Topic: Performance Measurement and Leveraging Results"
  • Tuesday, Dec. 14 @ 12 noon (Eastern): "TMC Topic: Payment Reform to Align Incentives with Quality"
Birthing From Within , provides mentor and doula workshops throughout the country. Upcoming Birthing From Within workshop sites include Brooklyn, NY, Abiquiu, NM, and San Diego, CA.

Midwifery Education Accreditation Council presents " Taking action to increase access to midwifery services in out-of-hospital settings ," Tuesday, Nov. 10, at the American Public Health Association's Annual Meeting and Expo.

Association pour la santé publique du Québec presents " Birthing the World " Conference, Nov. 25-26, in Quebec, Canada.

Academy of Certified Birth Educators , provides workshops for certification as a childbirth educator as well as birth doula training (labor support professional) in classes across the country. ACBE workshops are scheduled for Lapeer, MI, Kansas City, KS, Morgan Hill, CA, and Honolulu, HI.

toLabor: The Organization of Labor Assistants for Birth Options and Resources , provides workshops throughout the country. Upcoming toLabor workshop sites include Chicago, IL, Cincinnati, OH, Lincoln, NE, Boston/Jamaica Plain, MA, and Albuquerque, NM.

For Expectant Families


Mother's AdvocateVideo clips and print materials to help you have a better birth 


Making informed decisions about how you want to give birth is critical to achieving the healthy and joyous birth experience that you deserve.


Mother's Advocate , a service of InJoy Birth & Parenting Education, offers free video clips and print materials that will educate and inform you on how to have the birth you want - for both you and your baby.  


Visit the Mother's Advocate blog for guest posts from some of the birth community's most passionate, influential and exciting experts! A sneak peek:


"This week, I had the honor of attending another birth. This is the second birth I have attended since giving birth to Phoenix, and the 132nd birth I have attended total. I have always stood in awe of birth, and of women and their power to give birth. In the past, when a woman would hit that wall, the "I can't do this! This is crazy" kind of wall, I would speak to her with all the passion, dedication and encouragement I could muster. I would tell her that this was the moment, the eye of the needle, and that although it felt impossible, she could do it. She would do it, and she would meet her baby. I would speak firmly and calmly, telling her that although every part of her felt like it would break open, that indeed she would be made stronger by her birth, and by facing this moment of impossibility. That was before I had felt it myself."


Read more of this amazing guest post on the Mother's Advocate blog!

Additional Resources for Expectant Families:


About Us
You are receiving this e-CIMS News to keep you up to date on CIMS' activities, research, policy issues, and conferences that may be of interest to you. If you have suggestions on what resources or information you would like to see in upcoming editions of e-CIMS News, please e-mail us at .
CIMS is a not-for-profit organization recognized as tax-exempt under Internal Revenue Code section 501(c)(3). Our mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs.
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