Day 2 :
University of Massachusetts Boston, USA
Keynote: The role of continuous electronic fetal monitoring (CEFM) on childbirth outcomes: A population health study
Time : 09:15-10:00
Lisa Heelan-Fancher has experience in Quantitative Research which includes large datasets; as an Educator. Her primary area of research is focused on improving childbirth outcomes through best evidence and patient choice. She has taught maternity and women’s health at the undergraduate and graduate level, ethics to undergraduate students, and evidence based practice to graduate and doctoral students. Additionally, she has published articles in peer-reviewed journals, one of which was recently listed by the Agency for Healthcare Research and Quality in their “Safety Program for Perinatal Care” on fetal monitoring.
Statement of the Problem: The United States cesarean delivery rates in low risk women (healthy with a term pregnancy) vary widely across states ranging from 17.1% to 32.0%. This variation in cesarean delivery rates suggests that maternal factors alone do not explain the high rates, and may be related to what we are doing to women while they are in labor. One hospital labor practice that is routinely used on all pregnant women regardless of health risk status is continuous electronic fetal monitoring (CEFM). In the study to date that used a large data set to examine the relationship between CEFM and newborn mortality, post-term births were examined together with term births. Post-term births accounted for approximately seven percent of all births in that dataset, and are associated with worse neonatal outcomes. This is a problem as it suggests that the findings from the only large data set study could be flawed.
Methodology & Theoretical Orientation: Data were extracted from birth records from two states that used the 1989 United States standard certificate of live birth from 1992-2014. Birth outcomes such as neonatal morbidity and mortality, along with maternal outcomes such as primary cesarean were examined.
Findings: Use of CEFM in term pregnancies was not associated with improved outcomes in newborn morbidity (Apgar scores, p=.927), seizures (p=.101), or neonatal mortality: early (p=.398), late (p=.718), and post (p=.124), but was associated with primary cesarean deliveries (p=.003).
Conclusion: Use of CEFM in term pregnancies is not associated with improved birth or maternal outcomes. However, use of CEFM in term pregnancies is associated with increased maternal primary cesarean. Further evaluation of use of CEFM versus intermittent fetal monitoring in term pregnancies is warranted.
Caribbean School of Nursing-University of Technology, Jamaica
Keynote: Attitudes of nursing students towards individuals with mental illness before doing the mental health nursing course
Time : 10:00-10:45
Andrea Pusey Murray is a Senior Lecturer and Program Director for Undergraduate Nursing Program at the Caribbean School of Nursing, University of Technology, Jamaica (Papine Campus). She has published peer reviewed articles in journals such as International Journal of Nursing Science, Journal of Biomedical Science and Engineering and Mental Health in Family Medicine. She has authored a book chapter entitled, “Attendance and performance of undergraduate students in two nursing courses in a University in Jamaica”, in Advancing Education in the Caribbean and Africa and co-authored “Cultural Voices and Human Rights: Case Exemplars” in the Routledge Handbook of Global Mental Health Nursing. Currently, she serves on the Curriculum and Development Committee - Nursing Council of Jamaica. She holds membership with the Nurses Association of Jamaica and Sigma Theta Tau International Honor Society of Nursing - Theta theta Chapter. Her research interests’ focus on mental health, public health sexually transmitted infections and education.
The aim of this study was to examine the undergraduate nursing students’ attitudes toward individuals with mental illness. Furthermore, it was important to study the perception, attitude, of our students regarding mental illness, which will help in improving the care given to the mentally ill in the hospitals or in the community. A total of 110 undergraduate students were selected using the stratified random method. Data for the study were collected through the use of a questionnaire. The data were coded and entered into SPSS version 20. The findings of this study indicated that 30% of the nursing students agreed that “the best way to treat the mentally ill is to keep them at the hospital for years”, 59% disagreed with the statement. “Whenever a person starts showing signs of mental illness they should be taken to the health facility for treatment”, and 34% reported that the mentally ill should not be spoken about their sexual practices. It is noteworthy to report that 61% of the respondents from this study would not be comfortable working with a mentally ill co-worker who is maintaining their treatment regimen. Reducing the stigmatization of mental illness continues to be an important goal for mental health professionals. Every student nurse needs to be grounded in the basic principles of communicating with the mentally ill patients and provide patient-centered care in a culturally sensitive way. Considering the results of the present study, it seems that revision of the teaching strategies and modification of mental health educational programs of nursing schools are necessary.
Home Sweet Home Birth, USA
Anne Margolis is a Licensed Certified Nurse Midwife, OB/GYN Nurse Practitioner, Certified Yoga Teacher and Clarity Breath work Practitioner. She is a 3rd generation guide to mommas birthing babies in her family. She has helped thousands of families in her 20+ year midwifery practice and has personally ushered the births of over 1000 healthy babies into the world. Through her online childbirth course 'Love Your Birth', her online and in-person midwifery for pregnancy and postpartum support consultations, and her holistic gynecology offerings she infuses wisdom, compassion, inspiration, and joy into the entire process of women’s wellness from mama-hood to menopause. Her work, insights and advice have been seen on TV shows and movies including 4 episodes of “A Baby Story” on TLC and the Discovery Channel, and the award winning feature documentary, 'Orgasmic Birth.' She is featured on the upcoming documentary, “The Human Longevity Project” to be released on 5/18. She has been interviewed for local and national radio programs and podcasts. She has also been a featured speaker and expert panelist at distinguished events for Weil-Cornell School of Medicine, the University of Pennsylvania School of Nursing, RCC State University of New York School of Nursing, and BirthNet Association of Childbirth Professionals and Hudson Valley Birth Network to name a few. She has midwifed mommas and babies for over two decades, with clients describing her as “passionate, sensitive, big hearted, and a playful ball of light.”
What is my story - the cascade of interventions and birth trauma with my first and second, why did I become a holistic nurse midwife after OB nurse (why I am passionate about doing what I do) - to restore humanity, empowerment, confidence, and deep joy a woman and her family can experience in the process of having a baby, and to improve birth outcomes for mamas and babies - physically and psychologically (our country ranks near the bottom among other industrialized countries in outcome stats with high rates of maternal and newborn mortality and morbidity and birth trauma, despite escalating rates of cesarean and medical interventions, and soaring costs. What is birth trauma for moms (and babies - that is another interview; 0)? How common is it? What causes it? What are symptoms? How to prevent it and how to heal - for mom and baby? How can mothers take back their pregnancy and birth, if they really want to be healthy and have a healthy baby? How to prepare for a natural, minimal intervention birth, restore calm and confidence in your ability to give birth, tap into your inner calm, your inner goddess and warrior strength and ROCK your journey to birth.