In our continuing effort to transform your experience as an ACNM Annual Meeting attendee, we’ve invited a top slate of experts in maternity and women’s health care to speak on issues of concern in your professional life. Premier sessions address topics of broad significance and feature nationally-recognized advocates for maternal health.
Normal Birth in an Industrial Age: Keeping Risk in Perspective
Wednesday, May 25
8:00 - 10:30AM
Presented by: ACNM President Holly Powell Kennedy, CNM, PhD, FACNM, FAAN, and Andrew Kotaska, MD, FRCSC
With skyrocketing rates of intervention during birth in modern industrialized countries, how do we define normal birth? How do clinicians’ and women’s perspectives of risk and health influence normal birth rates? This talk will contrast "normal" birth with increasingly typical "industrial" birth and examine two major reasons for the erosion of normal birth: the tendency of modern obstetrics to over-estimate risk and the lack of a clear definition of "normal" birth itself. Common debates in “evidence-based practice” that hinder normal birth will be presented, as well as practical examples that can reverse this trend.
ACNM President Holly Powell Kennedy, CNM, PhD, FACNM, FAAN, is an internationally known researcher on midwifery practice and normal birth. She serves as the inaugural Helen Varney Professor of Midwifery at Yale University School of Nursing, where she leads faculty development in midwifery research. Kennedy’s research focuses on articulating and linking the work of midwives and childbearing care to health care outcomes. She is a retired colonel from the US Army Nurse Corps Reserve and a 2008 Fulbright Distinguished Scholar.
Andrew Kotaska, MD, FRCSC, is a leading expert who advocates for women’s informed choice across the spectrum of birth options and places. His steady, thoughtful, and inspiring use of evidence-based trials, clinical experience, and common sense are examples of why he has been invited to share the Opening Keynote Address with ACNM President Holly Powell Kennedy. Kotaska is the clinical director of OBGYN at Stanton Territorial Hospital, Yellowknife, Northwest Territories, Canada, and has developed a large following of care providers across North America. He is widely read and highly esteemed by midwives for his fearless promotion of informed consent and women’s ultimate authority over their choices, including vaginal birth after cesarean (VBAC), vaginal breech births, home birth, and limiting interventions that lead to operative delivery. We welcome Kotaska and support his dedication to women and providers working together to normalize safe childbirth.
Diversifying the National Midwifery Workforce: Integrated Leadership Designed to Eliminate Health Disparities Among MCH Populations
Thursday, May 26
9:15 - 10:15AM
Presenter: Jo-Anna Rorie, CNM, MPH, PhD(c)
Health care disparities persist as one of the nation‘s top public health challenges for the 21st century. Despite the progress made in reducing infant mortality and morbidity, the United States is still ranked 29th among developed countries. Infant mortality among African Americans is twice that of whites, and the infant mortality rate from prematurity and low birth weight for African Americans is almost four times that of white infants. Furthermore, twice as many Latina and American Indian/Alaskan Native women lack first trimester prenatal care, and the maternal mortality rate for non-Hispanic Black women is more than three times that of non-Hispanic White women. These health inequities point to a critical need to recruit, educate, and retain midwives from the communities most affected by disparities. Pursuit of a strategic and effective plan for action to develop a midwifery workforce that mirrors the diverse tapestry of America would open an untapped source of great skill and lead to a robust exchange of ideas about how best to serve this nation’s families. Such action carries great potential to mitigate the persistent health disparities among MCH populations in the United States, especially those most vulnerable to persistently poor outcomes. As midwives, we should be inspired to prepare a diverse work force that is grounded in art, advocacy, and scientific evidence that will bring fresh ideas and leadership to the long-held vision—that all families can be healthy, and together we can strive to build healthy communities.
Jo-Anna Rorie, CNM, MPH, PhD(c), is a graduate of the Yale University Nurse-Midwifery Program and Harvard University School of Public Health. She is an associate professor at Boston University (BU) in the Community Health Sciences Program with the Maternal and Child Health concentration. Her role at BU encompasses training and education for the School of Public Health Prevention Research Center, including responsibilities for public health and housing. Rorie has long been recognized as a leader in midwifery with seven years of service as associate editor for the Journal of Midwifery & Women’s Health. She has received the ACNM Excellence in Teaching Award, along with numerous other honors for work to promote social justice through care of high-risk mothers in their childbearing years and improving access to services that support health and safety. She recently completed a doctorate in social policy and management at Brandeis University.
Therese Dondero Lecture (Sponsored by the A.C.N.M. Foundation, Inc.)
Developmental Programming: A New Name for an Old Idea that Women’s Health Before and During Pregnancy is Critical to Long Term Health of Their Offspring
Friday, May 27
8:00 - 9:00AM
Presenter: Peter W. Nathanielsz, MD, PhD, ScD, FRCOG
The last twenty years has seen an explosion of exciting, fascinating, and critically important information on the influence of the maternal environment on the developing offspring and the potential long-term complications of poor maternal health, nutrition, and maternal stress on the child’s life-long health. This presentation will trace the historical background of the concept of developmental programming—the response to a specific challenge during a critical developmental time window that alters development with persistent effects on phenotype. Dr. Nathanielsz will present examples of how poor maternal nutrition (either too much or too little) can alter fetal pancreatic development and predispose to later life diabetes and how maternal stress can alter the setting of her child’s stress axis thereby predisposing to anxiety, depression, and other conditions. He will focus on the current epidemic of maternal obesity and steps that can be taken to avoid the adverse effects on maternal pregnancy outcome and offspring health.
Peter Nathanielsz, MD, PhD, ScD, FRCOG, is renowned for his research on the influence of maternal environment on developing offspring and has been featured in national and international press. He is author of Life Before Birth: The Challenges of Fetal Development and Life in the Womb: The Origin of Health and Disease.
Joint Risk Management: Do I Practice in a “High Reliability” Mother/Baby Unit?
Friday, May 27
1:00 - 2:00PM
Presenter: John Keats, MD
All obstetric providers want to achieve a goal of 100% healthy mothers and healthy babies. Unfortunately, much work remains to be done in our hospitals and birthing centers to achieve these desired outcomes. In this year's joint risk management session, Keats will reveal the components of “high reliability” mother/baby unit, including teamwork, communication, checklists, application of technology, and principles of just culture. Attendees will come away with a roadmap for applying these principles to their own practice setting.
John Keats, MD, attended Brown University’s seven-year Program in Medicine, and completed a four year residency in Obstetrics and Gynecology at UCLA Medical Center in 1982. He served as an obstetrician-gynecologist with the Air Force and served as medical director of Buenaventura Medical Group (BMG) in Ventura, California for 10 years. In 2007, Dr. Keats became President and Medical Director of California HealthFirst Physicians. He is the course director for ACOG’s Postgraduate course entitled “Quality and Safety for Leaders in Women’s Health Care” and is a member of ACOG’s Committee on Patient Safety and Quality Improvement. He serves as a lead site reviewer for ACOG’s Voluntary Review of Quality of Care program and is a member of that program’s national steering committee and chairs an ad hoc committee on office patient safety for ACOG. He is also chair of the California Patient Safety Action Coalition.
Holding the Space or Invading the Space: How Do We Impact Physiology During Labour and Birth?
Saturday, May 28
8:00 - 9:00AM
Presenter: Dr. Hannah Dahlen, RM
As midwives, we can’t hope to promote normal birth if we don’t understand how we can and do facilitate and inhibit physiology. Come to this closing premier session prepared to question your attitudes, beliefs, and practices surrounding birth. Through a series of direct inquiries into the physiology of birth positions, Dahlen will detail the challenges presented to today's birthing mothers and midwives. Her presentation draws on her recent research into physiologic birth positions in different settings, women’s experiences, and her observations as a practicing midwife.
Dr. Hannah Dahlen, RM, is president of the Australian College of Midwives—a role that has been important for women and midwifery around the globe. She is also associate professor at the School of Nursing and Midwifery, University of Western Sydney, as well as a published and respected researcher and clinician. Her research supports best practices and the autonomy of childbearing families in their birthing decisions. Her latest article, published in the September 2010 issue of the Journal of Midwifery & Women’s Health, investigates women’s perceptions of physical activity during pregnancy. In a 2007 Birth publication, she used Australian national data to compare “alongside hospital” birth center with in-hospital perinatal mortality and found significantly lower perinatal mortality rates associated with birth centers. It is an honor to welcome Dr. Dahlen to our premier circle as she shares her expertise in working with birthing families, and advocacy for freedom of choice in birth place even in the face of opposition.