About this Website

Framework for the Site

ACNM’s BirthTOOLS (Tools to Optimize Outcomes of Labor Safely), presents the evidence and offers targeted resources, protocols and other materials to assist clinicians and health care systems in implementing best practices that promote physiologic birth. The site was officially launched at the ACNM Annual Meeting and Exhibition in Denver in May 2014.

Practices that Promote Physiologic Birth

The site is framed around the background and value that physiologic approaches bring to childbirth for women, providers and maternity care systems. The first section highlights the evidence supporting care that promotes physiologic birth. It also outlines the linkages between promotion of physiologic birth and national efforts to improve maternity care for women and families. Calls for action to reduce the incidence of cesarean birth and increase rates of spontaneous vaginal birth are noted in combination with the introduction of new quality outcome measures to monitor progress in these areas. The next section outlines the role quality improvement plays as a change process to promote those care practices introduced in the first section. Through this lens, the FOCUS-PDCA approach is introduced which includes steps to follow to identify areas for improvement, including assessments to make and issues to consider prior to outlining the specific change element. The process outlined encourages all stakeholders to be engaged in implementing specific elements of change that meet their unique areas of interest or unit based needs. This leads into the next section which is the “Menu of Change” elements which include:

  • Promoting spontaneous onset of labor,

  • Transitioning into the birth setting,

  • Promoting progress in first stage labor,

  • Assessment of fetal well-being

  • Comfort and coping in labor,

  • Physiologic approaches to second stage labor,

  • Nutrition and hydration during labor,

  • Dyad care during the immediate post-partum phase.

Each element of change section includes an introduction to the evidence base to support the change, a review of key outcomes that result from the change, and a collection of resources that can assist maternity care professionals in implementing the change. Resources include model policies, guidelines from national organizations, algorithms, staff education materials and a list of references to support the information provided in the introduction of the section. Audit tools and exemplar policies are included in these sections and can be used as a template for other users.

TOOL BOX of Resources

There is also a general “TOOL BOX” that can be searched by the overall content area, such as “Comfort and Coping”; by type of resource (e.g., guideline, staff education, position statements); or by key word or phrase, such as “water immersion.” This function supports users of the site to location the resources they uniquely need to support their change process or to augment the processes they already have in place to maintain a specific care practice. A unique feature of the resources are “Stories of Improvement” which includes case studies highlighting institutions, practices or individuals that successfully implemented some of the care elements listed above.

Taken together, these valuable resources available in the tool kit website have been compiled and collated to make it easy for midwives and other maternity care professionals to implement the changes that are needed to improve spontaneous birth rates in the U.S. Visit www.BirthTOOLS.org after the annual meeting launch to find the tools you need to help you advocate for women, educate others, and articulate the value of midwifery care to maternity care stakeholders and the public.

Contributors to This Site

The following individuals have contributed to the development of specific text for use on this site:

A focus on physiologic birth: Amy Romano MSN CNM and Lisa Kane Low PhD CNM

A framework for Quality Improvement: Cathy Collins-Fulea MSN CNM and Amy Romano MSN CNM

Promoting Spontaneous Onset of Labor: Amy Romano MSN CNM

Transition to the Birth Environment: Lisa Kane Low PhD CNM

Assessing and Promoting Progress in First Stage Labor: Amy Romano MSN CNM

Assessment of Fetal Well-being: Tekoa King MPH and Amy Romano MSN CNM

Comfort and Coping: Ellise Adams PhD CNM and Amy Romano MSN CNM

Nutrition and Hydration: Ellise Adams PhD CNM and Andrea Christianson MS CNM

Promoting Physiologic Pushing in Second Stage Labor: Catherine Osborn PhD CNM, Lisa Hanson PhD CNM, and Lisa Kane Low PhD CNM

Dyad Care: Amy Romano MSN CNM and Lisa Kane Low PhD CNM

Unit Culture: Lisa Kane Low PhD CNM and Amy Romano MSN CNM

Reviewers of Site Content

External Reviewers

Debra Bingham DrPH, RN

Diana Jolles MSN, CNM

Tekoa King MPH CNM

Judith Mercer PhD CNM

Catherine Ruhl, MSN CNM

Mavis Schorn, Phd CNM

Saras Vedam MSN CNM

Subcommittee Reviewers

Melissa Avery PhD CNM

Andrea Christianson, MS, CNM,

Sharon Dalrymple, RN, BN, MED, LCCE, FACCE,

Lisa Kane Low PhD CNM

Audrey Levine, CPM, NACPM

Amy Romano, MSN, CNM,

Members of the Tool Kit Subcommittee

Lisa Kane Low PhD CNM ACNM, Chair of Subcommittee

Amy Romano, MSN, CNM, Consultant, Childbirth Connection

Ellise Adams, PhD, CNM, AWHONN Representative

Melissa Avery, PhD, CNM, ACNM General Member Representative

Andrea Christianson, MS, CNM, ACNM Chair Homebirth Section

Sharon Dalrymple, RN, BN, MED, LCCE, FACCE, Lamaze International

Lisa Hanson, PhD, CNM, ACNM, Division of Research

Tina Johnson, MSN, CNM, ACNM National Office Staff Liaison

Audrey Levine, CPM, NACPM Representative

Julia Martin, MSN, CNM, ACNM Student Representative

Corrine Stasko, ACNM Student Representative


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