MA1701: Teamwork Makes The Dream Work - Christine Morton, PhD

First Ten Minutes Is Missing From This Recording:
Collaborative efforts to improve maternal outcomes in the United States: As we work to improve measurement, analysis and prevention of maternal mortality and morbidity, while simultaneously implementing strategies to support vaginal birth, opportunities emerge to engage with local and national maternity care organizations to improve birth outcomes in the United States.

MA1702: MANA President Vicki Hedley, CPM, CM, MA

MA1703: Plenary 1 - The Politics Of Place – Wendy Kline, PhD

The Politics Of Place- Joseph DeLee, Home Birth, and the Rise of Modern Obstetrics: One of the most influential figures in 20th
century American obstetrics, and determined to wrest control of childbirth from midwives to obstetricians, Dr. Joseph DeLee was also keenly aware of the value of exposing medical students to the natural process of birth that occurred outside of the hospital. His promotion of the home birth setting as an effective learning environment for medical students inadvertently provided justification for sustaining home birth practices in urban areas later in the twentieth century. The history of midwifery and home birth includes moments of collaboration, not just conflict, with obstetricians, and is relevant to today’s reproductive politics.

MA1704: The Home Breech Option, Proper Selection & Technique Dr. Stuart Fischbein, OB/GYN

Vaginal breech birth options are disappearing from hospitals. Even when allowed, restrictive protocols may diminish successas fear has replaced con dence in most practitioners. Dr. Fischbein has been assisting with breech birthing for over 30 years, the last six in the home setting. We will discuss counseling people on risks and benefits, proper client selection and review breech techniques and maneuvers using narratives and videos of real breech deliveries, to enable the participant to practice problem-solving in real time.

MA1706: A Holistic, Evidence Based Approach To Cholestasis Prevention & Management - Ashley Jones; Darynee Blount, LM, CPM

Intrahepatic Cholestasis of Pregnancy (ICP), a complex liver disease which typically presents in the third trimester of pregnancy, in itself is generally not harmful for the mother, but poses an increased risk of complications to the fetus in severe cases. We will review the clinical presentation and diagnosis of ICP with recommendations for the holistic preventative support and treatment of clients with mild ICP in an out-of-hospital setting. We will also discuss parameters of the midwifery scope related to ICP and the potential need for collaboration, referral, and transfer of care.

MA1707: Black Women Birthing Justice - Dr. Sayida Peprah, PsyD

The “Battling Over Birth” research study justice project releases the power of collective knowledge and action. It is the documentation of 100 black women’s birth stories. These stories reveal repeated reports of medical coercion and over-medicalization. They unpack black women’s attitudes toward birth alternatives and set the platform to build a campaign for change.

MA1709: Midwifery In The Backbone - Joys & Barriers Of Rural Midwifery In America - Rebecca Hazel, Megan Koontz, CPM, LM & Elke Saunders, Midwife

Birth work in a rural area presents many speci c challenges and barriers while also providing amazing rewards for both the midwife and her clients. Midwifery challenges in these areas include a lack of educational resources for practicing and student midwives and their clients as well as awareness for the community regarding midwifery and safe birth practices. We will discuss potential solutions using current research and personal experience, and develop tools for sustainable practice and maintaining a variety of client options for birth care.

MA1710: Plenary 2 - Midwives In Cuba - Geradine Simkins, CNM, MSN; Marina Alzugaray, MS, CNM, ARNP; Diane Holzer, LM, CPM, PA-C ; Yeshi Neumann, CNM, MA, MPH & Ana Ester Rivero, MS, NM

As US and Cuba have reopened embassies in each other’s country, and travel bans have been loosened, the ongoing normalization
of relations provides opportunities for meaningful dialog and cultural exchange among women and midwives of two nations. This presentation will share the process of people-to-people educational exchanges that occurred among numerous Cuban women, traditional Cuban healers, Cuban health service providers, and American midwives in 2016 and 2017.

MA1711: Vitamin D Deficiency Effects On Pregnancy Outcomes; Who to Test, How to Treat and Options for Supplementation - Christian Toscano, CPM, LM

Vitamin D has an important role in pregnancy outcomes. There are numerous studies that show a correlation of insufficient Vitamin D levels with adverse pregnancy outcomes, an increased risk of preterm birth, preeclampsia, hypertension, SGA, fetal growth restriction, rickets, hypocalcemia and glucose intolerance. This presentation discusses the value of testing for Vitamin
D and provides a practice guideline for midwives for appropriate supplementation based on clinical evidence.

MA1712: Reclaiming Indigenous Midwifery- Stories Of Honoring Ancestral Knowledge, Resisting Medical Colonization And Returning Birth To Native American Communities - Rhonda Lee Grantham, Midwife & Autumn Cavender-Wilson

Midwives & healers have forever served their communities throughout the journey of pregnancy & childbirth. But for many
of today’s Native American families the realities of intergenerational trauma, forced relocation, and Indian Health Services policy have resulted in both disconnection and undeniable health disparities. But the resistance is growing and indigenous communities are demanding to keep their families together and their communities whole. As we honor the truth that birth is both a physical experience and a sacred ceremony, we are restoring family traditions while healing generations. From community- based doula programs to birth centers to midwifery at Standing Rock, the movement to Reclaim Indigenous Midwifery is here.

MA1713: How To Use A Racial Equity Toolkit For Decisionmaking In A Predominantly White Organization - Wendy Gordon, LM, CPM, MPH

This session is geared primarily toward leaders in predominantly white midwifery organizations. Decisions are often made by white leadership without being aware of the white-dominant context of those decisions. Incorporation of a racial equity toolkit can help to create an intentional pause in the decision making process to consider all policies, initiatives, and actions with a racial equity lens. Examples of the components of a midwifery- specific racial equity toolkit are included.

MA1714: Integrating Research Into Midwifery Communities - Evidence - Informed Practice In Action - Courtney Everson, PhD

Applying an evidence-informed practice (EIP) framework is critical for optimizing care outcomes and integrating research into midwifery care. The purpose of this session is to equip midwives with strategies for integrating research into their midwifery communities, moving EIP into action on professional realms, including peer review, inter professional collaboration and grand rounds, regulatory rule making and community health equity. We will work with a foundational toolkit of practical strategies for incorporating research into their local midwifery communities and in midwifery leadership work, maximizing efficiency and efficiency in consistently using scientific evidence to inform midwifery excellence.

MA1715: Healing Provider Trauma - Tara Tulley, CPM, LDEM, LCSW

This session will provide an overview of how provider trauma impacts birthwokers, and why past experiences get “stuck” within the ow of our neurobiology between the embodied brain and the mind. Participants will learn how to identify and change the negative beliefs and distress they experience based on past experiences and how to integrate those experiences in order to heal and become free of trauma for a more fulfilling career and life.

MA1716: The Carbohydrate & Pregnancy Controversy - Lily Nichols, RN, CDE

Conventional wisdom says that pregnant women should increase their intake of carbohydrates and that failure to do so could put their babies at risk. But where did those guidelines come from and do they have any truth behind them? This session will examine the evidence behind prenatal carbohydrate recommendations, how fuel metabolism changes during pregnancy, the controversy surrounding ketosis in pregnancy, and what we can learn from both ancestral prenatal diets and the modern gestational diabetes epidemic.

MA1718: Plenary 5 - Pittfalls During Resuscitation Of The Newborn In The OOH Setting: Key Failures in Neonatal Resuscitation and How To Prevent Them - Karen Strange, CPM, AAP/NRP Instructor

Karen Strange delves into the subject that she knows best: neonatal resuscitation. Using case reviews, she focuses on what gets missed, what is misunderstood and the role that fear and panic plays. She’ll explain the key failures as well as the key components to successfully breathing for a newborn. You’ll leave her lecture feeling a new sense of clarity and deep confidence in how you respond to babies at birth.

MA1719: Medi-Cal And Licensed Midwives – Challenges and Rewards to Providing Care Under California’s Medicaid System - Cristi Lewis, LM, CPM, CHom & Karen Pecora, LM, CPM, NE, AP

With 1 out of every 8 births in the US occurring in California, and half of all births in California being paid for by the Medi-Cal system, Licensed Midwives, who now have the ability to become Medi-Cal Providers, have a tremendous opportunity to serve a population that up to now has been unable to access midwifery care. Come learn the process of becoming a Medi-Cal Provider, what the nancial realities are to accepting Medi-Cal clients, brainstorm strategies on how to incorporate Medi-Cal clients into your practice, and hear stories from mothers who have given birth with a Licensed Midwife under the Medi-Cal system.

MA1721: Treating For Two - Pharmacology And The Midwife's Client - Vicki Penwell, LM

This session will make midwives aware of the challenges of drug use among pregnant women, including the home birth client. We will look at ways midwives can participate in studies and protect the health of their clients, while helping the client weigh what drugs are essential and which ones should be avoided if at all possible.

MA1722: Whiteness And Racism In Birth In The US - Heather Thompson, MS, PhD & Zoë Williams

This session will provide an overview of how racism emerges personally and systemically in general, and especially in birth. A discussion of the history of race in the US will provide a backdrop for the de nitions of important terms, historical review of race and birth in the US. Participants will learn about how race a ects birth outcomes through both physiologic factors and healthcare system inequities. This session will end with a discussion of the racial factors at work in the current “natural” birth movement and what participants can do to begin to incorporate racial awareness into their practice.

MA1723: OOH Claims - Allegations, Causes And Outcomes - Ann Geisler, CPCU, AU, AAI & David Pulley, MS-RMI

Concrete claims data is now available for 2013-2016 for OOH midwives that will be especially relative to MANA/CAM attend-
ees. Countrywide data will be scrutinized for claim allegations, causes and outcomes. We will explore root cause analysis, identify claim trends and learn risk management and loss control strategies to deal with prac- tice situations. Ultimately, this information will empower practitioners to utilize critical thinking to improve outcomes for mothers, babies and their families.

MA1724: Being Solution Focused In A Problem Focused World - Communication Skills to Build Bridges Rather than Walls - Dawson Britta Bushnell, PhD

New parents often come to healthcare providers looking for the “right” answers. But becoming a parent requires learning to look within for the answers that are right for us, rather than the illusive “right answer” that does not exist universally. As healthcare providers, we can guide parents to develop the skill of looking for solutions that work best for them and engage their inner parental resources so necessary during the years of parenthood. Additionally, as midwives, it is important to have skills for working with other healthcare professionals during transfers and other situations. Learning to build bridges rather than walls with other professionals improves the overall care of the parents you serve.

MA1725: Perinatal Cannabis Use - A Toolkit For Midwives - Heather Thompson, MS, PhD & Indra Lusero, Esq.

Marijuana liberalization is on the rise with more states legalizing some form of marijua- na. Elephant Circle has been supporting peri- natal families socially, scienti cally and le- gally for the past 4 years, and we have learned many lessons along the way. This session will raise the experiences of our clients as a way to talk about the various intersecting stakeholders and needs involved in support- ing parents who use cannabis. This session is designed to provide tools for midwives to navigate perinatal marijuana use in their own practice, including an education on the potential legal issues associated with cannabis- using parents and being mandatory reporters, and the current legal situation in California. 

MA1727: Domestic Violence Myths And Research - Cynthia B Flynn, CNM & Stanley Woody, LMHC, DVPTP (supervisor)

Typical Domestic Violence training in midwifery educational programs focuses on intimate terrorism (battering), which is primarily perpetrated by males on females but constitutes less than 10% of DV. This session will cover the other 90% of DV, which are perpetrated equally by men and women, how to screen for these types of DV, how they are handled by the justice system, the e ect of these types of DV on the children and therefore the next generation, when to refer, and tips for choos- ing good treatment programs. It includes video of unrehearsed responses to open-ended questions by a pregnant couple that chose to get treatment voluntarily.

MA1728: Disenfranchised Grief In Women Following The Loss Of Their Dreamed - Of Birth - Rumyana Kudeva, DSW, LCSW

The childbearing year is of utmost significance, carrying inherent possibilities of empowerment and self-actualization. Coming out of the childbirth experience with feelings of being uncared for or silenced, or even abused can cause serious long term psychological reactions postpartum. This session will provide birth professionals with the knowledge and skills to support women on their healing journey and “hold” space for them in their reconciliation with birth. We will also discuss self care and prevention of secondary trauma and burnout for birth pro- fessionals.

MA1729: Quality Improvement - Midwives Working Together For Excellent Care - Silke Akerson, CPM, LDM

Ongoing work on quality improvement is essential to safe, excellent and responsive midwifery care in any setting. In this session we will cover a number of possible elements of a quality improvement program including: transport improvement; targeted continuing education for specific concerns; mentorship; improving peer review; developing community practice standards; and community processes for addressing concerns about a midwife or practice. We will consider several specific current midwifery QI efforts in the US as a way to understand the strengths, considerations, and barriers of different approaches. 

MA1730: Midwives Responding To Natural Disasters - Vicki Penwell, LM

This session will explain the role of the midwife in a disaster response, and give invaluable training in how to create a safe birthing area when health care systems are down.

MA1731: Plenary 6- Centering Collaboration - Kimberly Seals Allers  

In this dynamic presentation, Kimberly draws on examples and lessons from over seven years of work in Southeast cities, Philadelphia and Detroit to create a blueprint for transforming birth and breastfeeding outcomes by leveraging the unique power of community.

MA1732: Plenary 7- The MANA STATS Fetal, Neonatal Mortality Review Project - Preliminary Findings and Implications for Practice - Marit Bovbjerg, PhD, MS, HBM; Jen Brown, LM; Melissa Cheyney, PhD, CPM, LDM; Courtney Everson, PhD & Saraswathi Vedam, RM FACNM MSN Sci D  

In this presentation, we will describe findings from a study designed to examine all fetal and neonatal deaths recorded in MANA Stats between 2004 and 2015. Using the three delays model as proposed by Thaddeus and Maine (1994), we will discuss rates of intrapartum and neonatal death in a large sample of more than 50,000 planned, midwife-led, home births in the United States and provide an in-depth thematic analysis of the primary contributors to mortality in the sample.

MA1735: Best Practices In Charting - Lessons Learned From The 4.0 MANA Stats Validation Project - Courtney Everson, PhD & Gina Gerboth, MPH, RM, CPM, IBCLC

Accurate charting is a critical midwifery skill. Charts are legal records, are important as a narrative of client experience and an accurate record for consult, referral and transfer of care or regulatory inquiries or litigation. Limitations of midwife charting were identified during the 4.0 MANA Stats Validation project. This session will provide skills and tools that will help midwives improve charting efficiency, clarity, and consistency, answering the questions of “why,” “what,” “how,” “where,” “when,” and “who.” Improvements in charting will support future validation studies of the MANA Stats perinatal data registry, protect midwives and clients during courses of care, and help advance midwifery professionalism. 

MA1736: Using Midwifery And Functional Medicine For Preventative Health Measures In Prenatal Care - Nikia Grayson, MPH, MA, MSN, DNP & Jodilyn Owen, CPM, LM

This session will explore the benefits of the functional medicine model and the midwifery model of care for preventative health measures in prenatal care, providing individualized, woman and family-centered care that allows individuals to take control and ownership of their health. By treating the whole person we are looking at how we can build relationships, empower the women we serve, and help improve family and community health outcomes.

MA1738: The Giving Voice To Mothers Study - Communities Of Color Speak Of Disrespect And Inequity In Access To Birth Options - Saraswathi Vedam, RM FACNM MSN SciD

The Lead Investigator of the Birth Place Lab and convenor of the Home Birth Summits speaks on new research and tools and the landscape of patient oriented research so we can better understand the discrepancies in women’s experiences of maternity care and treatment by care providers, based on race and socio-economic status. We will learn about global initiatives to address respectful maternity care and ways to increase equitable access to choice of birth place and autonomy in decision making for all women in the US.

MA1739: Plenary 8 Birth Justice 101 - Jamarah Amani, LM, CLC, Community Midwife

Black low income women have a higher primary c-section rate than any other group. In the United States, Black women are almost four times more likely to die from pregnancy- related causes than white women and black babies are more than twice as likely to die in the first year of life as white babies. How do interpersonal, institutional and internalized racism impact life and death in our communities? How do poverty, immigration status, economic disparity and various forms of discrimination ffect an individual’s ability to receive quality reproductive health care? What is the responsibility of midwives who have historically been advocates for and caretakers of people from marginalized communities?