Umbilical Cord Practices of Members of the American College of Nurse-Midwives.

Introduction: Mercer et al surveyed members of the American College of Nurse-Midwives (ACNM) about their umbilical cord clamping practices in 2000. Over the last 20 years, a significant body of research supporting delayed cord clamping (DCC) has been published. The purpose of this study was to learn how midwives today manage the umbilical cord at birth.

Preeclampsia and the Risk of Future Vascular Disease and Mortality: A Review.

Introduction: Preeclampsia increases a woman's long-term risk of vascular disease and/or death including chronic hypertension, myocardial infarction, heart failure, stroke, and venous thromboembolism. The literature suggests that maternity care providers may be unaware of this association.

Methods: A database search was conducted examining the long-term effects of hypertensive disorders of pregnancy using MEDLINE, Scopus, CINAHL, ISI Web of Knowledge, and the Cochrane Database of Systematic Reviews.

The Evolution of Individual Maternity Care Providers to Delayed Cord Clamping: Is It the Evidence?

Introduction: Studies of organizational strategies to incorporate evidence into practice and change provider behavior have shown limited success. The majority of existing research centers on influencing participants to change practice versus understanding what occurs when providers have successfully shifted to an evidence-based practice on their own. This study sought to explore the dynamics involved when individual midwives and physicians transitioned from a practice less based on the evidence to one with more scientific support.

How important are autonomy and work setting to nurse practitioners' job satisfaction?

Purpose: Nurse practitioners (NPs) have reported aspects of their jobs that they are more and less satisfied with. However, few studies have examined the factors that predict overall job satisfaction. This study uses a large national sample to examine the extent to which autonomy and work setting predict job satisfaction.

Does Prior RN Clinical Experience Predict Academic Success in Graduate Nurse Practitioner Programs?

Background: There is limited evidence on whether prior RN clinical experience is predictive of academic success in graduate nurse practitioner (NP) programs. The purpose of this study was to explore whether the frequently held assumption that more prior clinical experience is associated with better academic success in The George Washington University online NP programs.

Method: Applications (n = 106) for clinical NP students entering from 2008-2010 were examined along with data on academic performance.

Perspectives on implementing delayed cord clamping.

Expanding evidence supports delayed cord clamping (DCC) for both term and preterm infants. This article explores issues that may be keeping early cord clamping (ECC) in place as usual practice. Professional organizations almost universally recommend DCC for preterm infants, but some reserve recommending it for term infants only in resource-poor settings.

"The midwifery two-step": a study on evidence-based midwifery practice.

Introduction: To date, there has been little documentation of how practice-based midwifery networks in the United States might influence the transfer and development of knowledge in childbearing and women's health care. The first phase of this participatory action research project was to conduct a qualitative study with a community of midwifery practices to understand their perspectives on evidence-based practice and how an organized network could facilitate their work.

Methods: Midwives within the community of interest were invited by letter or e-mail to participate in individual or small group interviews about knowledge transfer, primary concerns of evidence-based practice, and potential for a midwifery practice-based research network.

Hope in hard times.

In the face of challenging times, advocates for women and their families in maternal-child health care continue to promote evidence-based and mother-/baby-friendly care. What qualities allow childbirth educators, doulas, nurses, and perinatal care providers to keep going even when the health-care practices around them often do not match their values? This editorial explores the impact of recent trends in which increasing utilization of elective technology in maternity care may affect the individual commitment of childbirth advocates. Borrowing from research on successful advocates in other fields, the author speculates on both why and how childbirth advocates sustain commitment and how "we will prevail.

Step 6: does not routinely employ practices, procedures unsupported by scientific evidence: the coalition for improving maternity services:

Step 6 of the Ten Steps of Mother-Friendly Care addresses two issues: 1) the routine use of interventions (shaving, enemas, intravenous drips, withholding food and fluids, early rupture of membranes, and continuous electronic fetal monitoring; and 2) the optimal rates of induction, episiotomy, cesareans, and vaginal births after cesarean. Rationales for compliance and systematic reviews are presented.

Step 1: offers all birthing mothers unrestricted access to birth companions, labor support, professional midwifery care: the coalition for improving maternity services:

The first step of the Ten Steps of Mother-Friendly Care insures that women have access to a wide variety of support in labor and during the pregnancy and postpartum periods: unrestricted access to birth companions of their choice, including family and friends; unrestricted access to continuous emotional and physical support from a skilled woman such as a doula; and access to midwifery care. The rationales for the importance of each factor and the evidence to support those rationales are presented.

Appendix: birth can safely take place at home and in birthing centers: the coalition for improving maternity services:

Although most women in the United States give birth in hospitals, a substantial body of research suggests that planned home birth or birth in freestanding birth centers have equally good or better outcomes for low-risk women. Out-of-hospital birth often facilitates mother-friendly care. Rationales and systematic reviews of both home birth and freestanding birth center birth are presented.

Step 7: educates staff in nondrug methods of pain relief and does not promote use of analgesic, anesthetic drugs: the coalition for improving maternity services:

Step 7 of the Ten Steps of Mother-Friendly Care insures that staff are knowledgeable about nondrug methods of pain relief and that analgesic or anesthetic drugs are not promoted unless required to correct a complication. The rationales for compliance and systematic reviews are presented on massage, hypnosis, hydrotherapy, and the use of opioids, regional analgesia, and anesthesia.