Teaching About Normal Birth in a tertiary hospital

Teaching About Normal Birth (in a tertiary hospital where birth doesn’t always feel normal) Lucy M. Candib, MD Stephanie Carter-Henry, MD Navid Roder, MD Sara G. Shields, MD, MS

Disclosures • Nothing to disclose

Agenda 1) Goal-setting— 10 min—for this session 2) Sharing our workshop— 5 min sharing, 10 min practicing one part 3) Brainstorming— 10 min—what problems have you had? 4) Action steps/summary— 30 min

Goal-Setting What do you want to get out of this part of the workshop?

Sharing Ideas: Umass Labor Support Workshop When: 2 hrs, 2 nd year spring (after most MCH rotations) Who: Multidisciplinary teaching: Senior residents, faculty from 23 health centers, community midwives and doulas, labor and delivery nurses What: Group: what does normal birth mean? (10 min) Group: labor support video (15 min) Group: self-reflection (15 min) Breakouts (20 min each station, rotate) Birth Plans Hands-on Labor Support Alternative Birth Positions Group: online resources (5 min) Summary (10 min)

Demonstrate: Alternative Labor Positions Emphasize: The power of this is in actually having the learners get down on the floor and try out the positions • So you get to do that now yourself • Men and women alike Experience and talk about the disempowerment of the lithotomy position

Evaluation Data Generic residency workshop evaluation 5 questions, Likert scale

Brainstorming: Just What IS “Normal” Birth? Our workshop begins with defining this Let’s do that now

Brainstorming: How To Teach “Normal” Birth What and how does your residency teach now about normal birth? • Who teaches this? • When in the residency? (we may do it too late) What is the best way to teach this? What do family medicine residents need to learn about normal birth? How do we know if we’re doing it “right”?

Challenges in Teaching Normal Birth Brainstorm in group • Culture of L and D floor • Access to anesthesia • Residents don’t see alternate positions as faculty not trained in them • Need to train home faculty first • Residents see only one style of delivery • (No) Access to midwives • How to evaluate this

Other Ideas (sharing) Online resources See handout Local community resources (doulas, etc)

Action Steps • • • What are you going to take home from this to your home residency? When will you plan to do this? How will you know it’s working?

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