Intro to Effective Communications, COMM 1010
COURSE PURPOSE & OVERVIEW The philosophy of the Communication 114 curriculum is driven by the conviction that midwives should be broadly educated as well as trained in their specialty. Communication competency is a critical skill, not only for student success, but also as a lifelong empowering tool for midwives in the Information Age. As one of the foundations for the profession of midwifery and continued lifelong growth and learning, this curriculum will assist students to develop intellectually as mature, educated, and responsible people. Opportunities exist through this class for the student to develop and integrate the skills necessary to help nurture all relationships through communication. Utilizing critical thinking skills will allow you, the student, to realize that:
1. The ability to write and speak clearly and effectively is one sign of an educated person. Taken seriously and followed diligently this course will help develop the skills needed to communicate in your chosen field.
2. One type of communication is the process of translating technical information into forms that different audiences can understand and use. You will learn about technical communication by selecting an authentic problem-solving project from the field of midwifery. You will write, format, and present this communication to an appropriate audience. You will then collect feedback, analyze it and learn from it.
3. You can learn firsthand what it means to more fully express yourself thereby providing leadership to others. As a participant in this program you will design a project that allows you to interact with others in your community. You will learn to express your ideas effectively in a way that brings out the agreement and cooperation of others.
4. Transforming the basis of your communication from one of reacting to others into one of creating effective communication strategies will help fulfill your commitments and expand your satisfaction.
5. By expressing yourself more effectively, others will relate to you, not from their past experience, but from the power you bring to the present and the communication possibilities for the future.
6. You will learn to communicate more effectively with target audiences by assessing their needs, creating consistent messages, and developing creative ways to promote your program.
7. Communication involves both sending and receiving messages. The ability to effectively speak, listen, and be sensitive to others is necessary for clearly interpreting information, ideas, and feelings.
8. Emphasis is placed on the interrelated components of Crucial Conversations in both interpersonal and professional communication.
SPECIFIC LEARNING OBJECTIVES At the completion of this course, the students will be able to demonstrate knowledge and skills in the following areas: At the completion of this course, the students will be able to demonstrate knowledge and skills in the following areas:
1. Demonstrate leadership skills through communication skills that contribute to positive relationships with others.
2. Develop a working knowledge and practical application of the language for crucial conversations in your life and work.
3. Demonstrates an understanding of the unique needs of an audience by tailoring the presentation to the audience demographic.
4. Prepare presentations to be “user friendly” and persuasive for those opposed to or misinformed about midwifery.
5. Pursue the opportunity you have, as a midwife, to empower individuals through effective communication.
I presented the following work to a live audience. I had some visuals to share with the group.
Mary Betsellie
COM1010
Winter – 2017
Erin Kaspar-Frett
What is the placenta?
The placenta is a temporary organ that begins to form at implantation. It is fully developed by the end of the first trimester. It attaches to the lining of the uterus and the baby is connected to it by the umbilical cord.
The main functions of the placenta are to bring nutrients and oxygen to the baby, remove waste and some toxins, and it provides antibodies against some pathogens. It also produces hormones that help your baby grow and sustain the pregnancy.
The birth of the placenta is called the 3rd stage. The placenta can be born anywhere from 10 minutes to an hour of the baby’s birth. In most hospital births the 3rd stage is heavily managed and the placenta will usually come out sooner rather than later. In a c-section delivery, the placenta is manually removed.
Delayed cord clamping, also called optimal cord clamping is where the umbilical cord is not clamped or cut until after pulsations have ceased, indicating that all of the blood has transferred from the placenta to the baby, or until after the placenta is delivered.
How much blood is in the placenta? About 1/3 or the babies blood remains in the placenta at birth. The shared blood amount in average size baby is 450 ml
300ml with baby at moment of birth about 150 ml still in placenta.
It takes anywhere from 2-5 minutes for the baby to receive the bulk of the remaining blood from the placenta. A good indication that all of the blood has transferred is to see if the cord has stopped pulsing.
At a homebirth, the placenta can be delivered first and remain intact until the parents decide its time.
Cord Milking is when the provider forces the blood out of the cord and into the baby manually. Studies have shown that there is improved outcomes in babies with milking but no significant difference between milking and delayed cord clamping. Cord milking can be especially beneficial if a baby needs immediate care such as resuscitation. The provider can quickly milk before clamping and cutting.
In December of 2016, ACOG changed their guidelines from immediate cord clamping to a 30 to 60 second delay.
ACNM ‘s guidelines for term newborns, delaying the clamping of the cord for 5 minutes if the newborn is placed skin-to-skin or 2 minutes with the newborn at or below the level of the introitus ensures the greatest benefit.
If there is no emergency the WHO recommends delayed cord clamping over milking. This allows for a more gentle transition from womb to outside world.
Benefits
Cord Blood Banking
Many expectant couple want to bank the cord blood but also want to delay. Is this possible? The answer is yes and no. If the clamping is delayed from 30 to 60 seconds, cord blood may still be collected. If it is delayed beyond 60 seconds, then it will not be possible to collect blood for banking.
Everything you ever wanted to know about placenta consumption
Placentophagy is the term used to describe ingestion of the placenta after childbirth.
Benefits of Placenta Ingestion
• Increased Milk Supply
• Decreased postpartum bleeding
• Enhances mood, with decrease in “baby blues” and postpartum depression
• Increased Iron intake
• Balances hormones
• Regulates sleep patterns
• Quicker overall recovery
Can also be helpful in menopause
Ways to ingest placenta
Placentophagy dates back more than 2000 years ago in China. Qin Shihuang, the first emperor of a unified China, is said to have designated placenta as having health properties some 2,200 years ago, and during China’s last dynasty, the dowager empress Cixi was said to have eaten it to stay young. A classic medical text from the Ming Dynasty (1368-1644) said placenta – which lines the uterus and is key to the survival of the fetus – was “heavily nutritious” and “if taken for the longer term... longevity will be achieved.”
There is scattered documentation of dried placenta prescribed as a remedy in Europe during the 1700’s.
However, it wasn’t until the mid-1980’s when Raven Lang, an American midwife who studied TCM, brought back this lost tradition by promoting placenta remedies during a MANA conference in the United States. The practice became popular on the west coast of the United States first and gradually moved across North America.
Getting your placenta from the hospital –All on Long Island allow it, some will only release when mother is discharged, Winthrop and Stony brook release to mother immediately.
The birthing Mother should state in birth the preferences or in a separate letter that she wishes to take the placenta. If the placenta is for ingestion, do not allow it to go to pathology. If the birthing mother is working with a professional placenta specialist for encapsulation or any other form of ingestion or ceremony, the specialist should be able to help guide the mother about hospital release.
Lotus birth and cord burning (home birth)
Leaving the baby, cord and placenta intact until the cord dries and releases completely on its own, is a “full” Lotus Birth. It can take 3 to 9 days to detach. Some feel this is a very gentle, natural and non-violent way for baby and placenta to be separated.
A “partial” Lotus Birth is waiting until the placenta has been born and left intact for an extended period of time before severing the cord. This can be anywhere from 15 minutes to a day or 2.
One option available to home-birth families is to burn the cord instead of cutting it. Cord burning was practiced in old China and was believed to help the Qi (Chi), latent in the placenta, move into the baby. According to Chinese Medicine, “Cord burning brings the element of fire to the birth. Warmth is essential for a baby’s well-being and mother’s recovery to full strength and ample milk supply.”
Cord burning takes anywhere from 10 to 20 minutes and is best done with 2 people. Cord burning kits are available online or the birthing family can easily collect the needed supplies individually.
Folklore
The Maori of New Zealand traditionally kept the placenta and the umbilical cord attached to the newborn baby. Colonizers discouraged this, and hospitals began burning the placenta. By the 1980s, the indigenous peoples of New Zealand were able to restore this important part of their culture so that the hospitals now return the placenta and umbilical cord to the mother if she so requests. The Maori call the placenta whenua and the umbilical cord pito. They believe that when the child’s whenua and pito are buried on Marae, tribal land, the individual’s sacred link with the Earth Mother Papatuanuku is cemented.
Some Indigenous peoples in Colombia South America believe the placenta to be a relative. They would never consider eating their placenta based on that idea. It is put into a clay pot and ceremoniously buried.
ACOG Women's Health Care Physicians. (n.d.). ACOG Recommends Delayed Umbilical Cord Clamping for All Healthy Infants
Retrieved from https://www.acog.org/About-ACOG/News-Room/News-Releases/2016/Delayed-Umbilical-Cord-Clamping-
for-All-Healthy-Infants
ACNM, Delayed Umbilical Cord Clamping, Position Statement Retrieved from
http://www.midwife.org/ACNM/files/ACNMLibraryData/UPLOADFILENAME/000000000290/Delayed-Umbilical-Cord-
Clamping-May-2014.pdf
Anderson, O., PhD. (2015, July 01). Delayed Clamping and Neurodevelopment at 4 Years of Age.
Retrieved from http://jamanetwork.com/journals/jamapediatrics/fullarticle/2296145
Blumenfeld, D. H. (2013, June 10). Placentophagy: A Pop-Culture Phenomenon or an Evidence Based Practice? Retrieved from https://www.scienceandsensibility.org/p/bl/et/blogid=2&blogaid=594
Chaparro, C. M., Neufeld, L. M., Tena, G., Eguia-Líz, R., & Dewey, K. G. (2006, June 17). Effect of Timing of Umbilical Cord Clamping on Iron Status in Mexican Infants: A Randomised Controlled Trial. Retrieved from
https://www.ncbi.nlm.nih.gov/pubmed/16782490
Green, A (2012, November 14). 90 Seconds to Change the World | Alan Greene | TEDxBrussels.
Retrieved from https://www.youtube.com/watch?v=Cw53X98EvLQ
Haelle, Tara. Delayed Umbilical Cord Clamping May Benefit Children Years Later.
NPR, 26 May 2015, www.npr.org/sections/health-shots/2015/05/26/409697568/delayed-umbilical-cord-clamping-may- benefit-children-years-later.
Simkin, P (2011, August 11). Penny Simkin on Delayed Cord Clamping.
Retrieved from https://www.youtube.com/watch?v=W3RywNup2CM&t=131s
1. The ability to write and speak clearly and effectively is one sign of an educated person. Taken seriously and followed diligently this course will help develop the skills needed to communicate in your chosen field.
2. One type of communication is the process of translating technical information into forms that different audiences can understand and use. You will learn about technical communication by selecting an authentic problem-solving project from the field of midwifery. You will write, format, and present this communication to an appropriate audience. You will then collect feedback, analyze it and learn from it.
3. You can learn firsthand what it means to more fully express yourself thereby providing leadership to others. As a participant in this program you will design a project that allows you to interact with others in your community. You will learn to express your ideas effectively in a way that brings out the agreement and cooperation of others.
4. Transforming the basis of your communication from one of reacting to others into one of creating effective communication strategies will help fulfill your commitments and expand your satisfaction.
5. By expressing yourself more effectively, others will relate to you, not from their past experience, but from the power you bring to the present and the communication possibilities for the future.
6. You will learn to communicate more effectively with target audiences by assessing their needs, creating consistent messages, and developing creative ways to promote your program.
7. Communication involves both sending and receiving messages. The ability to effectively speak, listen, and be sensitive to others is necessary for clearly interpreting information, ideas, and feelings.
8. Emphasis is placed on the interrelated components of Crucial Conversations in both interpersonal and professional communication.
SPECIFIC LEARNING OBJECTIVES At the completion of this course, the students will be able to demonstrate knowledge and skills in the following areas: At the completion of this course, the students will be able to demonstrate knowledge and skills in the following areas:
1. Demonstrate leadership skills through communication skills that contribute to positive relationships with others.
2. Develop a working knowledge and practical application of the language for crucial conversations in your life and work.
3. Demonstrates an understanding of the unique needs of an audience by tailoring the presentation to the audience demographic.
4. Prepare presentations to be “user friendly” and persuasive for those opposed to or misinformed about midwifery.
5. Pursue the opportunity you have, as a midwife, to empower individuals through effective communication.
I presented the following work to a live audience. I had some visuals to share with the group.
Mary Betsellie
COM1010
Winter – 2017
Erin Kaspar-Frett
What is the placenta?
The placenta is a temporary organ that begins to form at implantation. It is fully developed by the end of the first trimester. It attaches to the lining of the uterus and the baby is connected to it by the umbilical cord.
The main functions of the placenta are to bring nutrients and oxygen to the baby, remove waste and some toxins, and it provides antibodies against some pathogens. It also produces hormones that help your baby grow and sustain the pregnancy.
The birth of the placenta is called the 3rd stage. The placenta can be born anywhere from 10 minutes to an hour of the baby’s birth. In most hospital births the 3rd stage is heavily managed and the placenta will usually come out sooner rather than later. In a c-section delivery, the placenta is manually removed.
Delayed cord clamping, also called optimal cord clamping is where the umbilical cord is not clamped or cut until after pulsations have ceased, indicating that all of the blood has transferred from the placenta to the baby, or until after the placenta is delivered.
How much blood is in the placenta? About 1/3 or the babies blood remains in the placenta at birth. The shared blood amount in average size baby is 450 ml
300ml with baby at moment of birth about 150 ml still in placenta.
It takes anywhere from 2-5 minutes for the baby to receive the bulk of the remaining blood from the placenta. A good indication that all of the blood has transferred is to see if the cord has stopped pulsing.
At a homebirth, the placenta can be delivered first and remain intact until the parents decide its time.
Cord Milking is when the provider forces the blood out of the cord and into the baby manually. Studies have shown that there is improved outcomes in babies with milking but no significant difference between milking and delayed cord clamping. Cord milking can be especially beneficial if a baby needs immediate care such as resuscitation. The provider can quickly milk before clamping and cutting.
In December of 2016, ACOG changed their guidelines from immediate cord clamping to a 30 to 60 second delay.
ACNM ‘s guidelines for term newborns, delaying the clamping of the cord for 5 minutes if the newborn is placed skin-to-skin or 2 minutes with the newborn at or below the level of the introitus ensures the greatest benefit.
If there is no emergency the WHO recommends delayed cord clamping over milking. This allows for a more gentle transition from womb to outside world.
Benefits
- Increased iron stores, decreasing the risk for anemia
- Baby will receive the complete retinue of clotting factors.” In other words, the increased volume of blood will naturally increase blood platelet levels, which are needed for normal blood clotting.
- Delayed clamping also results in an infusion of “stem cells, which play an essential role in the development of the immune, respiratory, cardiovascular, and central nervous systems, among many other functions. The concentration of stem cells in fetal blood is higher than at any other time of life. ICC [immediate cord clamping] leaves nearly one-third of these critical cells in the placenta.”
- Increased blood volume / smoother cardiopulmonary transition -whether a baby “is premature or full term, approximately one-third of its total blood volume resides in the placenta. This is equal to the volume of blood that will be needed to fully perfuse the fetal lungs, liver, and kidneys at birth.
Cord Blood Banking
Many expectant couple want to bank the cord blood but also want to delay. Is this possible? The answer is yes and no. If the clamping is delayed from 30 to 60 seconds, cord blood may still be collected. If it is delayed beyond 60 seconds, then it will not be possible to collect blood for banking.
Everything you ever wanted to know about placenta consumption
Placentophagy is the term used to describe ingestion of the placenta after childbirth.
Benefits of Placenta Ingestion
• Increased Milk Supply
• Decreased postpartum bleeding
• Enhances mood, with decrease in “baby blues” and postpartum depression
• Increased Iron intake
• Balances hormones
• Regulates sleep patterns
• Quicker overall recovery
Can also be helpful in menopause
Ways to ingest placenta
- Raw
- Cooked into a meal
- Dehydrated, powdered and put into foods such as smoothies or chocolate truffles
- Dehydrated, powdered and put into capsules
- Made into a tincture
Placentophagy dates back more than 2000 years ago in China. Qin Shihuang, the first emperor of a unified China, is said to have designated placenta as having health properties some 2,200 years ago, and during China’s last dynasty, the dowager empress Cixi was said to have eaten it to stay young. A classic medical text from the Ming Dynasty (1368-1644) said placenta – which lines the uterus and is key to the survival of the fetus – was “heavily nutritious” and “if taken for the longer term... longevity will be achieved.”
There is scattered documentation of dried placenta prescribed as a remedy in Europe during the 1700’s.
However, it wasn’t until the mid-1980’s when Raven Lang, an American midwife who studied TCM, brought back this lost tradition by promoting placenta remedies during a MANA conference in the United States. The practice became popular on the west coast of the United States first and gradually moved across North America.
Getting your placenta from the hospital –All on Long Island allow it, some will only release when mother is discharged, Winthrop and Stony brook release to mother immediately.
The birthing Mother should state in birth the preferences or in a separate letter that she wishes to take the placenta. If the placenta is for ingestion, do not allow it to go to pathology. If the birthing mother is working with a professional placenta specialist for encapsulation or any other form of ingestion or ceremony, the specialist should be able to help guide the mother about hospital release.
Lotus birth and cord burning (home birth)
Leaving the baby, cord and placenta intact until the cord dries and releases completely on its own, is a “full” Lotus Birth. It can take 3 to 9 days to detach. Some feel this is a very gentle, natural and non-violent way for baby and placenta to be separated.
A “partial” Lotus Birth is waiting until the placenta has been born and left intact for an extended period of time before severing the cord. This can be anywhere from 15 minutes to a day or 2.
One option available to home-birth families is to burn the cord instead of cutting it. Cord burning was practiced in old China and was believed to help the Qi (Chi), latent in the placenta, move into the baby. According to Chinese Medicine, “Cord burning brings the element of fire to the birth. Warmth is essential for a baby’s well-being and mother’s recovery to full strength and ample milk supply.”
Cord burning takes anywhere from 10 to 20 minutes and is best done with 2 people. Cord burning kits are available online or the birthing family can easily collect the needed supplies individually.
Folklore
The Maori of New Zealand traditionally kept the placenta and the umbilical cord attached to the newborn baby. Colonizers discouraged this, and hospitals began burning the placenta. By the 1980s, the indigenous peoples of New Zealand were able to restore this important part of their culture so that the hospitals now return the placenta and umbilical cord to the mother if she so requests. The Maori call the placenta whenua and the umbilical cord pito. They believe that when the child’s whenua and pito are buried on Marae, tribal land, the individual’s sacred link with the Earth Mother Papatuanuku is cemented.
Some Indigenous peoples in Colombia South America believe the placenta to be a relative. They would never consider eating their placenta based on that idea. It is put into a clay pot and ceremoniously buried.
ACOG Women's Health Care Physicians. (n.d.). ACOG Recommends Delayed Umbilical Cord Clamping for All Healthy Infants
Retrieved from https://www.acog.org/About-ACOG/News-Room/News-Releases/2016/Delayed-Umbilical-Cord-Clamping-
for-All-Healthy-Infants
ACNM, Delayed Umbilical Cord Clamping, Position Statement Retrieved from
http://www.midwife.org/ACNM/files/ACNMLibraryData/UPLOADFILENAME/000000000290/Delayed-Umbilical-Cord-
Clamping-May-2014.pdf
Anderson, O., PhD. (2015, July 01). Delayed Clamping and Neurodevelopment at 4 Years of Age.
Retrieved from http://jamanetwork.com/journals/jamapediatrics/fullarticle/2296145
Blumenfeld, D. H. (2013, June 10). Placentophagy: A Pop-Culture Phenomenon or an Evidence Based Practice? Retrieved from https://www.scienceandsensibility.org/p/bl/et/blogid=2&blogaid=594
Chaparro, C. M., Neufeld, L. M., Tena, G., Eguia-Líz, R., & Dewey, K. G. (2006, June 17). Effect of Timing of Umbilical Cord Clamping on Iron Status in Mexican Infants: A Randomised Controlled Trial. Retrieved from
https://www.ncbi.nlm.nih.gov/pubmed/16782490
Green, A (2012, November 14). 90 Seconds to Change the World | Alan Greene | TEDxBrussels.
Retrieved from https://www.youtube.com/watch?v=Cw53X98EvLQ
Haelle, Tara. Delayed Umbilical Cord Clamping May Benefit Children Years Later.
NPR, 26 May 2015, www.npr.org/sections/health-shots/2015/05/26/409697568/delayed-umbilical-cord-clamping-may- benefit-children-years-later.
Simkin, P (2011, August 11). Penny Simkin on Delayed Cord Clamping.
Retrieved from https://www.youtube.com/watch?v=W3RywNup2CM&t=131s