103 W. State Street Boise, Idaho (208) 342-7642 www.idahoperinatal.org 1

Idaho Perinatal

Project News

Summer 2006

Inside This Issue 2. Certified Nurse Midwife Legislative Update 3. WIC Screening 4. Calendar of Events

Changes to this Newsletter Coming Soon!!!

We will be changing the format of this newsletter from a quarterly newsletter to an

every other month publication. Watch for the exciting updates.

The Idaho Perinatal Project and Mead Johnson Nutritionals present the Maternal/Child Nurse Managers Summit in McCall, Idaho, on October 11-13, 2006. This event is for Nurse Managers of Idaho hospitals and is a wonderful opportunity to share new and exciting information. This is a no cost event with great potential for learning and networking. If you are interested in attending, please call 208-381-4174 to register. The agenda and lodging information can be viewed at www.idahoperinatal.org.

The upcoming Idaho Perinatal Project Winter Conference will be held February 22-23, 2007, at Boise State University. We are excited about the agenda, which is constantly growing. Our keynote speakers include H. Eugene Hoyme, MD, specialist in general clinical genetics and dysmorphology and John Elliott, MD, whose practice, Phoenix Perinatal Associates, attracts women worldwide who became pregnant with high-order multiples after undergoing infertility treatment. The current agenda can be viewed at www.idahoperinatal.org.

103 W. State Street Boise, Idaho (208) 342-7642 www.idahoperinatal.org 2

IDAHO PERINATAL PROJECTADVISORY BOARD MEMBERS

Penny Beach, MDTerry Reilly Health ServicesClarence Blea, MDSt. Luke’s RMCSusan Bradford, MDPediatricianJonathan Cree, MDISU Family ResidenceProgramShoni Davis RN, DNScBoise State UniversityJanel GalbraithIdaho Hospital AssociationAndrew Jones, DOSt. Mary’s HospitalJudy Jones, RN, MSNSt. Luke’s RMC

Cheryl Juntunen, MS, RNSouth Central District HealthMartin Ladwig, MD, FACOGGate City Women’s HealthDiane Markus, RNCSt. Alphonsus RMCDarla Miller, RNCEastern Idaho, RMCLu Ann Nielsen, RNFranklin County Med. Ctr.Don Smith, MDMagic Valley RMCTeneale ChaptonDept. of Vital StatisticsPawel Zieba, MDSt. Luke’s RMC

STAFF: (208) 342-7642Sherry Iverson, RN, Coordinator

Sarah Jacobson, Project Assistant

Certi f ied Professional Midwife Legislative Update Written by Barbara Rawlings, CPM President, Idaho Midwifery Council Bonners Ferry, Idaho After many months of research, the Idaho Midwifery Council Board and Legislative Committee spent the last weekend in April putting together our first draft of a proposed legislative bill. Currently the board and our legislative committee members are reviewing & correcting it, then we will send it to our legislative council as well as to the Midwives Alliance of North America (MANA) and North American Registry of Midwives (NARM) for review. After that update we plan to circulate it among our member midwives for comments before our IMC conference in late July. Following that revision we feel it will be ready for a wider audience. We are encouraged by our progress and inspired by the positive response and cooperation we are receiving. We welcome your questions and appreciate your support.

Lending Library: What’ s New The Lending Library has had several new and exciting additions:

Advanced Childbirth Simulator – Includes male and female vinyl fetuses, a full-scale female torso, and six labor stations which represent conditions of the cervix and vagina prior to labor, during labor, and at birth in a primigravid woman. The simulator demonstrates cephalic or breech presentation, cesarean section, episiotomy, vertex presentation, and prolapse of the umbilical cord.

If you are interested in reserving the childbirth simulator, please visit www.idahoperinatal.org and click on the Lending Library Link or call 208-342-7642.

Advisory Board Resignations Melanie Harker and Kevin McTeague have resigned from the Idaho Perinatal Project Advisory Board to pursue new professional opportunities. We would like to thank both Melanie and Kevin for all of their hard work and wish them well in their future endeavors.

Funding Opportunity!

March of Dimes The Idaho Chapter community grants program is designed to invest in priority projects that further the March of Dimes mission, support national campaign objectives, and further the strategic goal of reducing disparities in birth outcomes. Proposals will be accepted from organizations with the capacity, competence and experience to accomplish project goals and objectives through one of the following strategies: 1. Increasing access to and quality of health care for

women and infants 2. Increasing availability of prevention services 3. Increasing availability of genetics services and

folic acid education For information or to obtain an application, contact: Rosa Carnot, State Director March of Dimes Idaho Chapter 3222 W. Overland Road Boise, ID 83705 800-336-5421 or (208) 336-5438

Restricted Use of Episiotomy Preferable Over Routine Use ACOG Today April 2006 - Routine use of episiotomy is not recommended, and clinical judgment remains the best guide to determine when to perform an episiotomy, according to the new Practice Bulletin Episiotomy (#71) published in the April issue of Obstetrics & Gynecology). Although episiotomy use became common in much of the 20th century, its use has declined in recent years. In 1992, more than 1.6 million episiotomies were performed, but by 2003, episiotomies had decreased to 716,000, according to the Practice Bulletin. It has been suggested that an episiotomy is indicated to expedite delivery in the second stage or in cases in which the likelihood of spontaneous laceration seems high. However, the data supporting these claims are largely descriptive or anecdotal. To read the rest of this article, please visit www.idahoperinatal.org and click on the News and OB Update links.

103 W. State Street Boise, Idaho (208) 342-7642 www.idahoperinatal.org 3

WIC Screening WIC is a federally funded program that provides services through the seven health districts and two tribal organizations in Idaho. WIC provides food and nutrition and breastfeeding counseling to low-income pregnant, postpartum and breastfeeding women, infants, and children up to age 5 who are at nutritional risk. Some common nutritional risks are underweight, overweight, and low hemoglobin. WIC weighs and measures children at least every 6 months at certification visits. The chart below shows some nutrition risks an infant or child could have based on their weight and height/length. WIC uses the most current CDC age and sex specific growth charts.

Nutritional Risk Infants and Children under age 2 Children over age 2

At risk for underweight Weight/Length ≤ 10th percentile BMI/Age ≤ 10th percentile

Underweight Weight/Length ≤ 5th percentile BMI/Age ≤ 5th percentile

At risk for overweight N/A BMI/Age ≥ 85th percentile

Overweight N/A BMI/Age ≥ 95th percentile WIC understands some children fall into different growth curves which may be considered within normal range for that child. For this reason, if an infant or child is considered to be overweight or underweight based on the nutrition risks identified above, they are referred to a dietitian to further assess the participant’s growth. Hemoglobin values are also routinely checked at the WIC clinic. The chart below indicates the requirements for testing hemoglobin levels. Hemoglobin levels are checked more frequently if a low value is received. A recheck from a low value usually takes place 2 months after the first check.

Category Frequency of Hemoglobin Testing

Pregnant One time when they are certified.

Postpartum/Breastfeeding One time when they are certified.

Infants and Children under age 2 Their first test is between 9-12 months and then every 6 months following. Premature infants have their first test at 6 months.

Children over age 2 Tested yearly if their previous hemoglobin value was normal. Tested every 6 months if their previous hemoglobin value was low.

For more questions regarding WIC screening measures contact your local WIC clinic.

Revised Education Guide for Fetal Heart Rate Monitoring Available

The fourth edition of Antepartum and intrapartum Fetal Heart Rate Monitoring: Clinical Competencies and Education Guide is now available. This essential document for managers and staff developers of perinatal units provides a fundamental framework for the core content of education programs, clinical practicums, and areas of competence for clinicians responsible for antepartum and intrapartum fetal heart rate monitoring. A new format was used for this publication: the document is presently available on a CD-ROM. To order, please go to the AWHONN store at www.awhonn.org/store or call 800-673-5499.

CDC Releases National Recommendations to Improve Health of Babies and Moms

The Center for Disease Control and Prevention (CDC), in collaboration with more than 35 federal, public and private partners, released national recommendations designed to encourage women to take steps toward good health before becoming a parent. The recommendations for preconception care were published in the Morbidity and Mortality Weekly Report (MMWR) Recommendations and Reports. To view this report, please visit www.idahoperinatal.org and click on the News Link.

103 W. State Street Boise, Idaho (208) 342-7642 www.idahoperinatal.org 4

Idaho Perinatal Project 103 W. State St. Boise, ID 83702

Non-Profit Organization U.S. Postage

PAID Permit No. 194

Boise, Idaho

CALENDAR OF EVENTS Event Maternal/Child Nurse Managers

Summit Meeting Date October 11-13, 2006 ~ McCall, Idaho Sponsor: Idaho Perinatal Project & Mead Johnson

Nutritionals~ 208-342-7642

Event Breastfeeding Under the Rainbow Date October 12-13, 2006 ~ LaConner, Washington Sponsor: Skagit Valley Hospital Family Birth Center ~ 360-428-BABY (opt #2)

Event Idaho Conference on Health Care Date October 25-27, 2006 ~ Pocatello, Idaho Sponsor: Idaho State University ~ 208-282-3155 Event 2007 Idaho Perinatal Project Winter Conference Date February 22-23, 2007 ~ Boise, Idaho Sponsor: Idaho Perinatal Project ~ 208-342-7642 www.idahoperinatal.org