Focus on preparation and support for labour and birth
IN THIS ISSUE:
Author: Denis Walsh
Author title: Associate Professor
Description: This editorial argues that we need to present place of birth choices in ways that are honest, accessible and meaningful
Description writer: Denis Walsh, Associate Professor, Nottingham University
Author: Amali Lokugamage, Francoise Barbira-Freedman
Author title: Amali Lokugamage, Consultant Obstetrician and Gynaecologist; Francoise Barbira-Freedman, Affiliated Lecturer in Medical Anthropology
Description: Achieving two main objectives of antenatal education, namely optimising normal birth outcomes for low risk pregnant women and improving the quality of birth experience for all new mothers (Ogden et al., 1997/2014), is linked with a cascade of health benefits indicated in research converging on the concept of ‘primal health’ (see www.primalhealth.org). Mothers’ mental wellbeing is paramount to thriving families and lightens the burden and cost of health care in the short, medium and long terms (Brixval et al., 2014; Gamble et al., 2002).
Description writer: Amali Lokugamage, Consultant Obstetrician and Gynaecologist, London, UK; Francoise Barbira-Freedman, Affiliated Lecturer in Medical Anthropology, University of Cambridge, UK
Author: Cathy Green
Author title: Midwife
Description: This article outlines some of the issues involved for women and their partners in deciding whether or not to plan a homebirth. It is intended as a practical tool to enable those working with families to begin or take up the place of birth discussion with women and their partners. It outlines and offers responses to some frequently asked questions and concerns of couples and provides practical tips on preparing for a homebirth that those working with women in the perinatal period may find helpful when discussing plans for the birth of a woman’s current or subsequent baby.
Description writer: Cathy Green, Midwife working with Homebirth Team at Birmingham Women’s Hospital, UK
Author: Barbara Hotelling
Author title: Clinical Nurse Educator
Description: ‘The health of mothers, infants, and children is of critical importance, both as a reflection of the current health status of a large segment of the U.S. population and as a predictor of the health of the next generation’ (Healthy People, 2010). It is clear from the research that continuous emotional and physical support has benefits for birth outcomes. Labor support doesn’t need to be limited to trained and certified doulas, but the support needs to be continuous, emotional, and physical. Doulas know that guiding family members in support of the mother creates a birth memory that can provide a loving and peaceful future for the child. They also know that everyone has a place on the mother’s team in caring for her medically, emotionally, spiritually, and physically so that her birth memories are positive ones.
Description writer: Barbara Hotelling, Clinical Nurse Educator, Duke University School of Nursing, North Carolina, USA
Author: Rhea Dempsey
Author title: Independent Birth Educator
Description: Normal physiological birth is under threat in many developing countries with concerning consequences for impaired hormonal physiology underpinning birthing capacity, breastfeeding and maternal behaviours (Buckley, 2015; Odent, 2013), disruption of the healthy human microbiome by birth practices, especially caesarean birth (Buckley, 2015; Harman & Wakeford, 2016) and the epigenetic effects of birth interventions, or the ‘epigenetic impact of childbirth (EPIIC) hypothesis’ (Dahlen et al., 2013). Supporting and protecting normal birth is urgent.
Description writer: Rhea Dempsey, Independent Birth Educator, Birth Attendant, Trainer, Counsellor, Author
Author: Nancy E. Suchman
Author title: Assistant Professor of Psychiatry
Description: Not all mothers with histories of substance use struggle as parents, but many of them do. Research has shown that, although quality of caregiving varies widely, as a group, mothers with histories of chronic substance use are at greater risk than mothers with no substance use history for losing custody of their young children (Grant et al., 2011; Choi & Ryan, 2006; Department of Health and Human Services, 1999). In observational studies, mothers with substance use disorders have demonstrated lower levels of sensitivity and responsiveness to their young children’s emotional cues and marked oscillation between intrusive, over-controlling behavior and passive withdrawal (Hans et al., 1999; Burns et al., 1997). Recent developments in the neuroscience of addiction and parenting may help to explain the marked absence of sensitivity and the dramatic juxtaposition of parenting behaviors.
Description writer: Nancy Suchman, Assistant Professor of Psychiatry, Yale University School of Medicine, Department of Psychiatry and Child Study Center, USA
Author: Susan A. Bers
Description: When Nancy Suchman invited me to be a clinical consultant to her work developing a parenting intervention for mothers suffering from substance misuse, Mothering from the Inside Out, I was delighted to be working with her and her research team for the benefit of an under-served population. My major role in Dr. Suchman’s project was to meet with mothers while in recovery from substance misuse for 12 weekly, individual sessions focusing on developing their capacity to mentalize. In her article (published in this Journal) Dr. Suchman has described how a mother’s capacity to mentalize for herself and her child might foster a more secure attachment between them, and thereby help the mother promote her child’s emotional regulation and development. My job as a therapist was to help each mother tune into her own and her child’s experiences and mental states so that she might interact with her child in a sensitive and responsive way.
Description writer: Susan A. Bers, Yale University School of Medicine, Department of Psychiatry
Author: Clare Rohan
Author title: Family Nurse
Description: Group Family Nurse Partnership (gFNP) is a programme, currently undergoing a randomised controlled trial, for mothers and partners with low social capital to develop their potential as individuals and as parents. It is a semi-structured, psycho-educational programme delivered in a group setting during pregnancy and infancy with the same goals as Family Nurse Partnership (FNP), underpinned by FNP theories and also using materials and approaches adapted from FNP (Griffiths, 2016). Effective co leadership and co-facilitation in gFNP creates an environment that supports group members to explore relevant topics, make informed decisions about their parenting and life choices and implement plans to make changes. Group dynamics are often complex and co-facilitation ensures that whilst the lead facilitator focusses on guiding the group through the topic of discussion, the co-facilitator monitors and gathers in the richness of the aside interactions and supports the less confident individual voices to be heard. Every communication or contact at every point in this process can contribute to a positive outcome.
Description writer: Clare Ronan, Family Nurse, FNP Sessional Communication Skills Educator, South Tyneside Foundation Trust, UK
Author: Rebecca Schiller
Author title: CEO
Description: The human rights in childbirth charity, Birthrights, was founded in 2013 by a group of UK lawyers, service users and healthcare professionals with a vision to defend the dignity of childbearing women by promoting respect for human rights.
Description writer: Rebecca Schiller, CEO Birthrights
Author: Family Links
Description: This teaching activity for use with groups aims to help parents think about their future as parents, a couple, and as a family, and to increase their understanding of their baby’s development before and after birth, and the importance of attunement, attachment and empathy
Description writer: Family Links Antenatal Nurturing Programme