Friday, September 25, 2009

The Six Lamaze Healthy Birth Practices

Lamaze International has put out a series of videos and research summaries called The Six Lamaze Healthy Birth Practices.

These are "evidence-based statements about the care practices that ease and facilitate labor, prevent complications, and protect breastfeeding and early mother-infant attachment."

Amy Romano, CNM, discusses the Healthy Birth Practices on the excellent birth blog, Science and Sensibility. She makes the following very vital point (emphasis mine):

Each of the Healthy Birth Practices is supported by decades of high quality research. I like to think of the practices as “the basic needs of childbearing women.”

Some women will need high tech monitoring and intervention to birth safely, but the standard should be care that supports and facilitates the normal physiologic processes, intervening with the safest, most effective, and least disruptive approach only when a medical need arises and with fully informed consent.

Routinely depriving women of The Healthy Birth Practices makes birth unnecesarily difficult, and complications more likely.
Amen to that. Let me say it again:

The standard of care should be that which supports the normal physiologic process and the best outcomes for mothers and babies.

Unfortunately, this can be difficult to come by in many hospitals today....and especially so for women of size.

The Six Healthy Birth Practices

The Six Lamaze Healthy Birth Practices include:
  1. Let labor begin on its own
  2. Walk, move, and change position
  3. Have continuous support
  4. Avoid unnecessary interventions
  5. Get upright and follow urges to push
  6. Keep baby with you
Now, all of these sound very common-sense, don't they? And yet very few women giving birth these days in the hospital actually get to experience these.

Think of the typical hospital birth you see on TV or in the movies. Although vastly over-dramatized for plot purposes and dramatic tension, they do represent the way most women experience birth in this country these days.

Most of these women are flat on their back (or nearly so) in labor, with tubes and wires all over the place and often an oxygen mask on their face. Most are given contraction-strengthening drugs during labor, have pain medication of some type, and have their water broken artificially at some point in labor. Most push on their backs or semi-sitting with their knees pulled way back to the side, holding their breath or screaming as nurses and partners count to 10 and urge them to "push harder!"

This is the reality of birth for most women in this country today, but it does not reflect the safest and most effective ways of giving birth.

Even more frustrating, the Six Healthy Birth practices is DEFINITELY not the reality of birth for most fat women in this country today, and as a result, women of size and their babies are being put at risk unnecessarily.

Go See These Videos

I can't recommend these videos and handouts highly enough. They are presented in clear and simple language, yet effectively communicate why these care practices are so important.

Even better, the videos have accompanying handouts for those who wish more details on the research behind them. For research geeks like me who like to see proof of claims of efficacy and safety, this kind of information is vital.

If you or a loved one are pregnant now (or even just considering the possibility of a baby in the future), I strongly urge you to watch these videos.

The complete set of videos can be found here:

I like this set of videos so much I will be reproducing* them, one by one, on my website over the next few weeks. They each contain such important points about birth that each one deserves its own moment in the sun for discussion and as much exposure as possible.

However, I particularly want to highlight how each Healthy Birth Practice is used even less often with women of size, and how this negatively impacts fat women's ability to birth safely and normally.

So in this new series of posts, I will be highlighting the Six Healthy Birth Practices (one at a time), talking about the importance of each one, and embedding the Injoy video associated with that Practice. Then we will discuss how that particular healthy birth practice is even less utilized with "obese" women than across the general obstetric population, when in fact these practices may be even more important for women of size to have optimal outcomes.

I hope these will be as enlightening and useful to you as they have been to me.

*Special thanks and kudos to Lamaze and Injoy Videos for making these freely available on the internet. What a tremendous public service!


Jill Arnold said...

Those videos are amazing and I'm so thankful to have them just a link away. There really were no mainstream videos of upright birth that are from a respectable source and easily accessible. Now there is one.

Amy Romano said...

Thank you so much for posting this, and linking to the videos. I agree (though I suppose I'm biased) that it's all just common sense, not rocket science!

Bonnie said...

I don't if this is the right place to ask a question, but here goes. I recently changed to a new ob/ 31 weeks gestation. My other doctor was extremely disrespectful and not at all on board with natural childbirth practices. My new doctor seems better, but she did make sure to tell me that fatties like me have an increased risk of cesarean. How true is that? Is there something about the fat itself that is causal? Or is it a correlation that could be attributed to other a lack of activity during pregnancy or gestational diabetes or incompetent doctors?