Labor Repose

Labor Repose
LaborPayne during her 6th homebirth (9th baby) at age 44

Tuesday, March 15, 2011

CIMS- Day Two

Day two of CIMS started with a session titled, "Building a Woman and Family Centered Medical Home" I was enthralled by this presentation given by Warren Newton MD and Adam Zolotor MD, two family physicians offering evidence-based, humanized care with a practice model that most midwives would find enviable. They described a practice that included a midwife/lactation consultant, a second nurse practitioner, a social worker and a centering prenatal model. They provided ample proof of why we need more primary care physicians and fewer specialists.

Michele Laura MD, presented on the consequences of Near Term Birth. I can't get enough of this topic. It is so critical to get the word out that near term is not term. These babies look fine but they aren't fine. Healthcare consumers need to know the true risks of medically induced preterm delivery. The talk was followed by the viewing of a video created to warn moms of the risks of preterm delivery. I thought great, here is a teaching tool I can use. The video was well made but left me with an uneasy feeling. It featured two moms who went into preterm labor through no fault of their own, who ended up with babies in the NICU. This is not quite the same as moms electing induction without a medical reason. It felt a little preachy to hear on OB telling women to stay pregnant for at least 39 week (why not 40?) especially since physicians started this whole thing by selling women on inductions and making them think there were little to no risks involved. You can view it and judge for yourself: Even with my reservations, this might be an adequate tool for those trying to stem the tide of social inductions. We have to start somewhere.

The next session was one I had been waiting for: Michigan Health and Hospital Association's Keystone OB by Morgan Martin, and Tami Michele, DO. The Keystone project is an obstetrics collaborative piloted in 16 hospitals in Michigan intiated by physicians to prevent preterm birth, lower c/s rates, introduce low dose pit, and other measures of decreased perinatal morbidity. I love physician driven models as they appear to be the ones that work. Since this model of practice change is initiated by physician champions and backed by administrative policy changes, it presents some real hope to the problem of harmful obstetrical practices. Tami Michele is a midwife in physician's clothing and a hero to our cause. She used to practice here in my city but relocated to her home state: our loss is Michigan's gain...

I was excited to hear Robbie Davis Floyd's presentation on MotherBaby Childbirth Initiative (IMBCI) in which she described her upcoming demonstration projects in Quebec, Brazil, Austia, and Mozambique to introduce mother-friendly concepts into current practice. Robbie never disappoints.

Representations of breastfeeding was an interesting presentation featured three mini presentations on how long term breastfeeding and breastfeeding of older children has been featured in the media, the public perception of lactation consultants, and replacing negative frameworks with positive ones. All very interesting stuff and good food for thought.

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