Season 6 Episode 7: Safely Preventing Primary (NTSV) Cesarean Delivery—A Conversation with David C. Lagrew Jr. M.D.
Release Date: 12/13/2022
S8 E6: Expert Insights: Latest Updates on Gestational Diabetes with Lily Nichols, RDN
InCast
Gestational diabetes changes the direction of many women’s pregnancies. Once the determination is made, things are not so straightforward after that. In this podcast we will explore how the path to birth changes once a diagnosis is made and what women can do to have a birth with as few complications as possible. We also look at what women can do to prevent the diagnosis in the first place. We discussed this important topic with Lily Nichols, who is a Registered Dietitian and Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for...
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S8E5: Comforting Mothers Who Have Experienced Infant Loss with Elizabeth O’Donnell of Aaliyah in Action
InCast
When a mother has the devastating experience of leaving the hospital without a baby and perhaps only a memory box, many in our society expect them to get on with living and go back to their normal life. But their life is changed forever, and many don’t recognize or acknowledge that. Today we will hear the story of grief, anger, a battle, and finally, a life’s purpose for one mother who had to walk this hard path. Through her mission, she struggled to get family leave extended to grieving parents, so no one would have to suffer as she did. She also discovered the importance of...
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S8 E4: The Latest in Treating Substance Use in Pregnancy and Breastfeeding With Dr. Kaylin Klie, MD, MA of UCHealth
InCast
Join us for the latest information on perinatal addiction. We will explore the most commonly used substances that affect the lives of families and their babies during pregnancy and postpartum. We also discuss the new legislation in some states that has changed the way that parents with substance use issues are treated. Since it’s been proven that punitive measures do not lead to change with people who have this complicated problem, new laws were put into place with the hope that women with substance use issues start prenatal care earlier. You’ll also learn how educators and...
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Season 8 Episode 3: Mama Bird: Serving the Community Through Compassionate Doula Services
InCast
Mama Bird Doula Services' mission is to improve the maternal health outcomes for Black, Indigenous, and other People of Color (BIPOC) and their babies in their community. They believe that all birthing persons and their families should feel Safe, Seen, and Heard. Through lived experience, the founder of Mama Bird, Birdie Johnson, came to understand the importance of having complete support and information to make decisions for the best possible outcomes. Knowing that this support and information is often missing, she made it her mission to be sure that others would have a better...
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S8 E2: Nurse-Family Partnership: The Difference 1,000 Days Can Make
InCast
For more than 40 years, the Nurse-Family Partnership has been improving the lives of first-time mothers and their babies! Nurses from the organization work with families for the first 1,000 days, from pregnancy until the baby reaches 2 years of age. You have probably heard of this community health program but may not have been sure of all they do. Listen in to learn more about their successes with the more than 380,000 families that NFP nurses have served since 1996. Perhaps some of your clients would benefit from the program! Our guests are Jane Pray, Sara Lynch, and...
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S8E1: Birth a World Away: How One Organization Is Making a Difference in Africa with Dr. George Mulcaire-Jones of Maternal Life International
InCast
Most of us listening today live in a well-resourced country and have access to skilled obstetrical/perinatal care. Although we do not have a perfect healthcare system here in the U.S., it is hard to imagine the realities of birth in the places in Africa we are going to talk about today. When complications arise in the U.S. and other western countries, there are medications, supplies, and trained providers to respond in most cases. But in Africa, there may not be any skilled birth attendants or the equipment they need to save lives during a birth if things go awry. ...
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Season 7 Episode 6: 1 Kick, 2 Kicks, 7 Kicks More! A Stillbirth Prevention Program With Megan Aucutt of Healthy Birth Day, Inc – Count the Kicks
InCast
How can a free app help prevent over 30% of stillbirths in Iowa? Join us as we discuss the amazing organization that founded the project now used by many pregnant people to do just that. Megan will take us through the history of the organization and the development of the Count the Kicks app and other educational materials available on their website. She will also share the background and definition of stillbirth. The fact that stillbirth affects about 21,000 babies every year in the US should help us all understand how important it is to help parents take preventable...
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Season 7 Episode 5: Family-Centered Care in the NICU with Megan Teague
InCast
About 10% of newborns will spend some time in the NICU, and you probably know at least one family who has spent time there. Join us for an inside look at the NICU with Megan Teague as she shares a vivid story of what caring for babies and families looks like on a daily basis. You will learn how to incorporate information about a potential stay in the NICU into your interactions with pregnant families to make them aware but not overwhelmed. This information can also help you understand the scope of work that goes on in the NICU and how to support families with newborns in the NICU as...
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Season 7 Episode 4: Perinatal Suicide Prevention with Lindsay Lebin
InCast
Join us to better understand the poignant topic of perinatal suicide. Perinatal suicide is the leading cause of maternal mortality from pregnancy to 1 year after birth, accounting for 23% of all maternal deaths. Listen to learn about the static risk factors that can increase the chance of suicide, along with. some dynamic risk factors that may appear for the first time in pregnancy and postpartum. Understanding the warning signs is important for all who work with pregnant and new mothers/birthing persons. In our role with families, what can we do to listen and refer...
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Season 7 Episode 3: Resiliency for Birth Workers with Nicole Heidbreder
InCast
While witnessing the miracle of birth can be exhilarating, it is often wrought with circumstances that create stress, confusion, grief—and sometimes even burnout— in nurses, caregivers, doulas, and other birth workers. The COVID and post-COVID period has brought even more tension into the mix with restrictions and staffing issues. Listen to explore the problems and discover some solutions to make life as a birth worker more resilient and satisfying. Nicole Heidbreder has worked as a Hospice Nurse and Labor and Delivery Nurse in various capacities for the last 10 years...
info_outlineListen in as we discuss promoting Vaginal Nulliparous Term Singleton Vertex (NTSV) birth to decrease the risk of maternal morbidity and mortality. Dr. Lagrew agrees with a past president of the Society for Maternal-Fetal Medicine, Vincenzo Berghella, who said, “Physicians do need to balance risks and benefits, and for some clinical conditions, cesarean is definitely the best mode of delivery. But for most (NTSV) pregnancies that are low risk, a cesarean delivery may pose greater risk than vaginal delivery, especially risks related to future pregnancies.” Working to decrease the number of cesareans that are not strictly for clinical conditions is something we can all work on. Educators, nurses, community health workers, and others can use the information Dr. Lagrew shares to help people avoid the first cesarean. This will not only lower unintended outcomes of the initial cesarean like hemorrhage and infection but also prevent problems in subsequent pregnancies.
Dr. Lagrew is a maternal-fetal medicine specialist and physician informaticist with a particular interest in maternal quality improvement. He recently retired as Medical Director of Women’s and Children’s services for Providence St. Joseph-Southern California and as a Providence System Provider Informaticist in Obstetrics. He has started his new role as Chief of Service, Maternal Fetal Medicine at Hoag Healthcare. He holds triple board certification in Obstetrics/Gynecology, Maternal Fetal Medicine, and Clinical Informatics. In addition to these administrative and leadership roles, he continues to actively author numerous peer-reviewed publications and book chapters. He is a clinical professor in the Department of Obstetrics and Gynecology at UC Irvine. He is the immediate past chair of the Society of Maternal-Fetal Medicine’s Clinical Informatics Committee.
Listen and Learn:
- That the absolute lowest risk delivery is a vaginal delivery after a previous vaginal delivery
- The rate of cesarean birth compared to vaginal births in the US now
- How an NTSV protects the woman’s long-term health, especially if she plans to have more children
- How midwives may have a lower cesarean rate due to their practice of admitting to the hospital later during labor
- How the shared decisions help prevent primary cesarean births
- How having a wide range of cesarean rates, state by state, is actually a good thing
- A sneak preview of the US’s ARRIVE Study compared to an upcoming study out of Canada
- That robust childbirth education about risks and benefits including an explanation of complications and outcomes will benefit parents and will likely decrease the cesarean rate
Resources & Mentions:
- Nation’s Ob-Gyns Take Aim at Preventing Cesareans
- Safe Prevention of the Primary Cesarean Delivery
- Childbirth Connection info on cesarean resources
- California Maternal Quality Care Collaborative (many states have similar organizations)
- Email Dr. David Lagrew: [email protected]
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