Monday, March 9, 2009

Reporting on CIMS

I came away from the 2009 CIMS Forum feeling like the take home message was the same as we all know: the maternity care system is messing up women and children. It was interesting to me to find out what different people are doing in different places.

I went to one presentation that discussed violations of the Mother-Friendly Childbirth Initiative as violence against women. The researchers (from Canada) qualitatively analyzed women's experiences (using interviews) that showed how women felt victimized by their maternity care. The researchers put together a really cool little chart that helps to illustrate it and I'm planning on filling one out with events from my own birth experience. I am just gratified that it is being framed in those words--that violations of informed consent are violent acts being perpetrated against women. I hope that the awareness becomes more accepted. I felt that their presentation and Solace for Mothers presentation worked well together, because they made the case for us that birth professionals are causing trauma and then we were able to follow up with the message "this is the outcome for women who experience that trauma and this is how we can help."

There was talk at the conference that the powerpoints from many of the presentations will be available on the CIMS website at some point, including the one I participated in for Solace for Mothers.

I also finally attended the Birth Survey marketing training and I realized that since I helped edit the training manual and powerpoint presentation that I pretty much knew all of it. But I did meet Nasima and Elan (the co-chairs of the Birth Survey Project) and it was really good to be able to meet them in person and visit a little bit. Here is a run-dowm of some of the Birth Survey results that Nasima unveiled: The sample of people who are responded so far is a little more educated that the national average, but not shockingly so. The most typical time for women to complete the survey is actually 9-15 months postpartum so marketing ambassadors are now being told to target pediatricians offices (and they will be more like to post the info than OBs because peditricians aren't going to be as threatened by the results). Probably most surprising is that the birth outcomes are pretty inline with the national data: the C-section rate isn't too far off, the percentage of hospital births, etc. Nasima did find that the questions regarding if you would recommend a provider, if a provider answered questions well and were respectful were highly correlated to whether a woman ranked that provider positively or negatively. So it appears that those questions are good indicators of overall quality and if women are saying they had a good experience.

Henci Goer gave a really good presentation on interpretting the research. She pointed out that a lot of birth activists are citing "Evidence Based Care" as the answer to the maternity care problems (think of the new report that came out a couple of months ago). I saw alot of that too but it must be realized that a lot of research is inherently flawed, that some researchers mess with their data, others draw conclusions not supported by their data, etc. Its stuff that I already knew, as a researcher, but may not be known by those who don't have the background in research. I think its a good thing to get the word out about.

For most of the conference, I was just making due since I had Willem with me. One day I couldn't find any childcare for him so he ended up attending the sessions with me. He did great and didn't appear to be a disruption to anyone but I didn't get as much out of it as I would have if he had been able to stay home. I'm not complaining though because it was still a very good experience. I'm happy to have learned what I did, and met the people that I did.

At one point, the different CIMS committees did overviews of their work and I'm kind of drawn toward working with the Informed Consent Committee. Coming up in the Winter 2009 issue Journal of Perinatal Education will be an article compiled by that team called "Informed Decision Making in Maternity Care." Another article with Maddy Oden as the lead author will be published in the May issue. Solace for Mothers is working on a tool that would be available for expecting mothers to use when choosing their maternity care provider. It may be an advantagous partnernship for CIMS and Solace to work together.

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