Research summaries for normal birth

In this column, the author summarizes four research studies relevant to normal birth. The topics of the studies include the clinical and behavioral benefits of skin-to-skin contact after birth; the effect of a group model of prenatal care on preterm birth risk and breastfeeding success; the harmful effects of a brief interval of electronic fetal monitoring at hospital admission; and barriers to access to midwifery care.     

Welcoming Transparency

In this column, the editor of The Journal of Perinatal Education (JPE) discusses why there is a need for transparency to improve maternity care. The editor also describes the contents of this JPE issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote normal birth.     

Home birth matters-for all women

Although it remains rare in the United States, planned home birth has drawn increasing attention and criticism in the mainstream media and has come under attack from organized medicine. Yet, recent peer-reviewed studies contribute to the evidence base supporting home birth as a safe option for low-risk women attended by skilled midwives. The author of this editorial argues that home birth is an important cultural touchstone in the landscape of American maternity care.     

Jonah’s Birth

Rachel Goldstein shares her experience of exploring options related to care provider and place of birth early in her pregnancy. Goldstein and her husband, Marc, after reading and research, chose midwifery care and a home birth. She shares the story of a long labor at home supported by her husband, her doula, and her midwife. Her positive attitude, her ability to use various comfort strategies, and the support she received throughout labor contributed to being able to give birth naturally and ecstatically to her son Jonah.     

Continuing Education Module: Persuasion: The Key to Changing Women's Ideas About Birth

Although standard maternity care is not evidence-based and, in many cases, increases risks for mothers and babies, few women make birth decisions that reflect this knowledge. This column discusses persuasion as a way to change women''s ideas about safe, healthy birth. The relationship between persuasion and choice is discussed, and the differences between presenting information and persuading women that natural birth is the safest and healthiest way to give birth are explored.     

Water Birth at Home: Two Perspectives

In this column, a grandmother, with a long history as an author and activist for normal birth, and her daughter, a new mother, offer their unique experiences of a water birth at home, attended by family members and midwives. Their unique perspectives demonstrate the trust in the normal birth process that is possible for every birth.     

Hitting the Right Notes

In this guest editorial, the author discusses her personal birth experiences, how her health-care provider''s perceptions affected her care management, and how advocates for mother-friendly maternity care can impact the perceptions of health-care providers, families, and communities by using the most powerful messages about the value of natural birth.     

Coping With the Unexpected in Childbirth: A Thematic Analysis

This article reports original research that describes new mothers'' experiences of birth and maternity care. Qualitative data were collected through a survey on birth satisfaction, which included space for women to provide comments about their birth and experience of care. Thirty-nine women provided comments that were analyzed using the thematic analysis method. Two themes emerged from the women''s experiences: “Unexpected birth processes: expectations and reality” and “Coping with birth: the role of health-care staff.” Participants described unexpected birthing processes, their experiences of care, and maternity care staff''s contributions to coping with birth. Implications for practice for childbirth professionals include promotion of physiologic birth, respectful person-centered care during all phases of perinatal care, and the value of childbirth preparation.     

Finding our way

LONG BEFORE I GOT PREGNANT, MY HUSBAND AND I BEGAN TO PREPARE FOR THE KIND OF BIRTH I HAD ALWAYS IMAGINED FOR MYSELF: peaceful, normal, and without medication or unnecessary medical intervention. In the fall of 2008, I got pregnant. At that same time, I started a new career as a labor and delivery nurse in a hospital that specializes in high-risk labor and birth. My daughter's journey into this world turned out to be the beautiful normal experience we had always imagined. This special experience also helped shape the kind of care I offer as a new labor and delivery nurse.     

Continuing Education Module The Courage to Birth

Childbirth educator Kathryn McGrath reflects on fear and courage and comes to see some levels of fear as a normal part of the process of pregnancy and birth and not something to be brushed aside. In this article, originally presented as a keynote address in 2005 at the Lamaze International Annual Conference, McGrath discusses fear during pregnancy and birth and presents ways in which the childbirth educator can acknowledge and accept women’s fears, and help find the courage they need to give birth.     

In This Issue—Preparing for Birth During the COVID-19 Pandemic

In this column, the editor of The Journal of Perinatal Education discussed how the COVID-19 pandemic has altered many aspects of promoting normal pregnancy and birth practices. 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.     

In Search of a Common Agenda for Planned Home Birth in America

Leading maternity provider organizations in North America have been in conflict about birth at home and birth centers, debating issues related to safety, access, the value of obstetric intervention, and patient autonomy. In today’s environment, childbirth educators and doulas are often required to explain to parents why physiological birth and evidence-based, low-technology methods of labor and birth care are not available in every setting, and why maternity providers disagree about birth place. There are very few regions in the United States where home birth providers are integrated into interprofessional provider networks that allow for seamless care across birth settings. In October 2011, multidisciplinary leaders met at a Home Birth Consensus Summit in Warrenton, Virginia, to discuss the status of home birth within the greater context of maternity care in the United States. This article describes the intent and outcomes of the summit. Four of the nine consensus statements developed at the summit are of particular interest and importance to mothers and families and, hence, to childbirth educators and advocates. Consumers, educators, and birth advocates are encouraged to widen the circle, identify communications experts, lead individual projects, or serve as advisors.     

Witnessing a Natural,Safe, and Healthy Birth

In this column, the editor of The Journal of Perinatal Education discusses her experience witnessing a natural, safe, and healthy home birth. 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 normal birth.     

Teaching in a patient-centered medical home

Teaching Lamaze International classes in a patient-centered medical home allows the childbirth educator the best environment for giving evidence-based information and empowering parents to give birth their way. Patient-centered medical home facilities and providers practice evidence-based care and adhere to the principles of family-centered maternity care. In patient-centered medical homes, women can expect to give birth using the Lamaze Healthy Birth Practices and to fully participate in their care with appropriate interventions and the right to informed consent and informed refusal.     

The adoption of children from out-of-home care: The understandings of key decision makers in Victoria,Australia

Adoption is one of a range of options that can provide children in out-of-home care with permanency when they are unable to be reunified with their birth parents. This paper reports on how the adoption of children from out-of-home care is understood by professionals involved in making decisions about the permanent placement of children in out-of-home care in Victoria, Australia, where adoption is rarely used. Data were collected through a single, face-to-face semi-structured interview with 21 professionals; eight child welfare specialists, eight adoption and permanent care specialists and five judicial officers. The adoption of children from out-of-home care was primarily understood as a child-centered practice that can afford children stability and a sense of belonging. Adoption was largely viewed as a voluntary process dependent upon the consent of a child’s birth parents. Adoption and permanent care specialists were the only group to refer to the dispensation of parental consent as a means of obtaining an adoption order. Most decision makers understood that contact between children and their birth parents is possible following adoption, but this was not understood by all judicial officers or all child welfare specialists. Children’s connection to their cultural heritage was viewed as important to the consideration of adoption for children in out-of-home care. This research provides insight into the foundations upon which decision makers may appraise adoption, within a hierarchy of options, as a potential outcome for children in need of permanency.     

Safe Prevention of the Primary Cesarean Delivery: ACOG and SMFM Change the Game

Safe Prevention of the Primary Cesarean Delivery, a joint statement of the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, changes the rules of maternity care management. The statement reviews the research and uses the findings to make practice recommendations. This article discusses the major recommendations and their importance in decreasing risk and increasing safety for mothers and babies. The articles in the current issue of the journal are also reviewed.     

Healthy Birth Practice #6: Keep Mother and Baby Together— It’s Best for Mother,Baby, and Breastfeeding

Mothers and babies have a physiologic need to be together at the moment of birth and during the hours and days that follow. Keeping mothers and babies together is a safe and healthy birth practice. Evidence supports immediate, uninterrupted skin-to-skin care after vaginal birth and during and after cesarean surgery for all stable mothers and babies, regardless of feeding preference. Unlimited opportunities for skin-to-skin care and breastfeeding promote optimal maternal and child outcomes. This article is an updated evidence-based review of the “Lamaze International Care Practices That Promote Normal Birth, Care Practice #6: No Separation of Mother and Baby, With Unlimited Opportunities for Breastfeeding,” published in The Journal of Perinatal Education, 16(3), 2007.     

Legacies,Transitions, and Advancing Normal Birth

In this column, the new editor of The Journal of Perinatal Education discusses the significance of legacies, transitions, and advancing normal birth. The editor pays tribute to the legacies left behind by former editors Francine Nichols and Sharron Humenick and shares her vision for The Journal of Perinatal Education as it transitions into the next phase of advancing normal birth. 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 normal birth.     

Exploring the Group Prenatal Care Model: A Critical Review of the Literature

Few studies have compared perinatal outcomes between individual prenatal care and group prenatal care. A critical review of research articles that were published between 1998 and 2009 and involved participants of individual and group prenatal care was conducted. Two middle range theories, Pender’s health promotion model and Swanson’s theory of caring, were blended to enhance conceptualization of the relationship between pregnant women and the group prenatal care model. Among the 17 research studies that met inclusion criteria for this critical review, five examined gestational age and birth weight with researchers reporting longer gestations and higher birth weights in infants born to mothers participating in group prenatal care, especially in the preterm birth population. Current evidence demonstrates that nurse educators and leaders should promote group prenatal care as a potential method of improving perinatal outcomes within the pregnant population.     

Creating Community

In this column, the editor of The Journal of Perinatal Education describes ways that Lamaze International is helping to create a community for those who share a common interest in promoting, supporting, and protecting natural, safe, and healthy childbirth. 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 normal birth.