Writing this on January 1st, it seems all too appropriate to be writing about plans. Most of us are contemplating our plans and goals for the next year. Some may be planning to conceive. Others are planning and preparing for childbirth. I have been thinking a lot lately about plans, the process of planning and the often unexpected outcomes.

In the next few days, you might sit down and set some goals for this year. You might even map out a plan to reach those goals. For example, I would like to get into better shape.  To do that, I need to start running again and ideally run at least 3x a week. In reality, that may not happen every week (or even in the majority of weeks!). Does that make the goal ridiculous or worthless? Is it pointless for me to attempt a goal that I may not reach? NO!

The Birth of A: an Epic Journey 

Drumroll please...

Lace is the winner of this beautiful Storch wrap.

Thanks to everyone that shared Birthin' with Love around the web. I hope you'll continue to spread the word. Look for another blog give-away to "share the love" in January.

Help Spread the Love and Birthin’ with Love will wrap you in a buttery soft Storchenwiege wrap, just in time for the holidays!

As many of you know, I (Kari Niedermaier), have been supporting expecting families for 11 years…helping them to stay healthy and low risk, avoiding unnecessary interventions, supporting freedom of choices based on knowledge of alternatives, strengthening their partnership, and embracing their birthing and parenting journeys.  When the twins blessed our lives in 2009, my birthing and parenting support took a backseat. Now that all the kids are older, it’s time to return more fully to my calling and YOU can help!

Learn More About This Beautiful Wrap....

As a family-centered midwife, doctor, doula, or childbirth educator, you probably pride yourself in providing individualized care for women and their families. I know that I do. I also love learning about the cultural and religious heritages of my friends, neighbors, and clients.  I assumed I was pretty culturally competent. After the 2011 Child Health USA and Women's Health USA reports documented persistent racial disparities in maternal and infant mortality,  I took a closer look at my childbirth services. I was dismayed to realize that some of the tools I regularly use in my childbirth education and doula services fall far short of being culturally competent.

Take, for instance, several birth priorities exercise I use. Almost all of them assume that mom and Dad or Partner will primarily be making the decisions about pregnancy, birth, and breastfeeding. But what if the partner takes a back seat in this situation to Mom’s mother or mother-in-law, per cultural tradition? Do you invite mother or mother-in-law to all doula prenatal and postpartum visits? How do you support the partner in this situation?
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Also, I teach my clients about Mother Friendly practices, but nowhere do I specifically ask about their cultural beliefs about non-medical practices that support the health and well-being of mom and baby (some cultures believe that colostrum is bad, that wearing a ribbon or band around the belly will  ensure baby is born healthy, and that inactivity may cause a difficult birth.)  Assessing these beliefs and helping the family to clarify healthy practices is important to an optimal pregnancy and birth.

After considering the weaknesses of some of my teaching tools, I have decided to include the following questions and activities in my childbirth education and doula services:

• Incorporate the following questions into doula consult or first prenatal and all childbirth education priority exercises:
  • Tell me about who will support you during labor, birth, and the postpartum period (instead of specifically naming/expecting the partner).
  • How will family members participate in your pregnancy, childbirth and parenting?
  • What do you and your family usually do to remain healthy during your pregnancy and for your birth?
  • What actions and rituals are important to you and your family after birth?
• Read the following book on Health Literacy and update my materials accordingly: Teaching Patients with Low Literacy Skills by Doak, Doak & Root, 1996 (free download)
•  In an effort to clarify the families resources and values and to remind the family that “It takes a Village” to raise a child, I am going to have each family complete an Ecomap like the one found here.

Do you consider yourself culturally competent? What tools do you use to best serve clients with cultural and religious heritages that differ from yours?