Walker: How did you discover your love of research?
Cheryl: It began during my graduate studies at Yale University. There I received my masters in nursing degree plus became a certified nurse-midwife. At Yale, research is a way of life. The value of research as the most important way to systematically improve patient care becomes ingrained in you. With my master’s degree I could read and critique research studies and apply the findings to my obstetrical clinical practice. I was a knowledgeable consumer of research but I wanted to do more. Five years after receiving my MSN I began my doctoral studies at Boston University. I wanted to be able to discover new knowledge not just apply it to clinical practice. So I knew I would need my doctorate to learn more about research designs and statistics.
Walker: Who were mentors and how did they offer guidance?
Cheryl: 15 years ago when I joined the faculty at the University of Connecticut School of Nursing, I met my most valued mentor. He was Robert Gable, Ed.D, a professor in the School of Education. At that point in my research program I had done numerous qualitative studies on postpartum depression and I wanted to develop a screening scale for postpartum depression. I wanted to use the words I had heard repeatedly from the mothers in my studies to develop the items on the scale. In my doctoral program I had not had a course on instrument development. I knew I needed to consult with an expert psychometrician. How fortunate was I that Dr. Gable, who had written one of the top textbooks on instrument development in the affective domains, was on faculty at UCONN. For the past 15 years he has been my mentor in instrument development.
Walker: How did you first encounter qualitative methodology?
Cheryl: My graduate work at both Yale University and Boston University was totally quantitative. My first study after receiving my doctorate was a quantitative study; that was what I knew and felt comfortable with.
It was a study on the relationship of maternity blues and postpartum depression. After completing that study it became clear to me that to improve the care to mothers suffering from postpartum depression, their voices needed to be heard in order for clinicians to better understand this devastating mood disorder. At that time I was teaching at Florida Atlantic University and on faculty there was one of the pioneers in qualitative nursing research, Patricia Munhall, Ed.D. She was the person who first introduced me to this powerful methodology of qualitative research.
Walker: How have your experiences of conducting qualitative versus quantitative research differed?
Cheryl: I love doing both qualitative and quantitative research. I am a firm believer that for a research program to be most valuable it needs to be knowledge driven and not method limited to either quantitative or qualitative methods. I guess one of the big differences in my experiences conducting both types of research comes in the data collection phase. My quantitative studies, such as when I developed and tested the Postpartum Depression Screening Scale, required much larger samples than my qualitative studies did. My latest quantitative study was a randomized control trial examining the effect of a diet enriched in DHA during pregnancy on postpartum depressive symptoms. I conducted this study with Dr. Carol Lammi-Keefe and Dr. Michelle Judge, both PhDs in nutritional science. It was a longitudinal study that went from 20-22 weeks of pregnancy to 6 months postpartum. Recruitment of the sample was challenging not to mention retaining the participants for 6 months postpartum through multiple data collection points.
Walker: How does someone know they are a researcher?
Cheryl: I guess it is when you get up in the morning and working on your research project is what you can’t wait to do. It is the part of your job that you love the most. You have a love for discovering new knowledge in order to improve patient care.
___________________________
The next and last installment of this interview will include Cheryl’s thoughts on internet-based data gathering, the future of research, and working in a male-dominated field.
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Sign in nowThanks for your interviews Walker, introducing Cheryl to LI community is so appreciated. I hope I get to meet her in person someday! Looking forward to #3.
Hi Annie,
I was so struck by her insight that prevalence rates for PTSD could be as high as 18%. And the universal presentation and incidence globally while not shocking, is a good reminder of how desperately we need to prevent, screen, and treat PTSD following childbirth.
Walker and Cheryl, thank you for this fascinating and informative interview series.
With regard to PTSD: why are we not regarding transvaginal ultrasound as an aggravator? Word on the street is that women hate this; the device is like – excuse me – a dildo on a gun. Yet nobody’s taking feedback from patients. They’re told, ‘It’s best for your baby’ (despite lack of evidence. We should be adapting the technology to the patients, not forcing the patients to accept the technology. This is a form of institutional rape & has got to go. http://vaginal-ultrasound.com/
Such a great piece,Darlene.
History is an invaluable component to deeper understanding. The treatments of Silas Weir Mitchell dominated mental health as well. Confinement became the core theme in Foucault’s post positivist work on madness. Clearly there are so many links…thanks for a great article.
Thank you for this interview and clarification of the screening roles. I was quite concerned about the blurring of roles in this matter. I use EMDR for release of birth trauma, it is an evidence based psychotherapeutic method for PSTD and other trauma used by the Department of Defense for veterans and also endorsed by the Israeli and Irish governments.
Great article with many links and implications. Yes, why are women confined? A rhetorical question on my part and one with many levels.
Great feedback from all. Thank you. While I can’t speak for Cheryl, from my own experience, I agree completely with you Dr. Hikel regarding the intrusive nature of the transvag US. Particularly for women with hx of CSA–the mixed messages are so confusing and the emotional outcome deleterious.
Kathy, thank you for your input. I am hoping to bring an article/interview with Phyllis Klaus regarding her work with EMDR and birth trauma as well. Thank you for sharing your use as well. And I hear your concern regarding the blurring of roles and screening. I really appreciate Cheryl’s clarity, and hope we all engage in ongoing conversations about screening and prevention.
Tomorrow Cheryl shares about doing research (my favorite part) and it is so interesting. Hope you enjoy it.
we really do not have much to offer in terms of treatment for preterm labor, preeclampsia, vaginal bleeding, etc and so providers can feel that at least they are doing something, right!?
In researching this topic, it was amazing to see that there really is little to no scientific backing for bed rest. Pretty darn amazing given that 3/4 of a million are prescribed a baseless prescription annually! But like Judith has said, it may be that providers need to feel like they are doing something. But the NEED to feel like you are doing something and actually DOING something (i.e. effecting change and creating a positive outcome) are two very different things. Although the road is slow, there is research being done and hopefully more evidence based treatments for high risk pregnancy complications will be implemented in the near future.
This is a very interesting topic and I think the discussion will only increase as more women choose to delay parenting to concentrate on careers. As women rightfully gain more equal rights in the workplace, although this is a slow process, childbirth will be delayed. It’s positive to see that studies are being undertaken, so we can analyse the risks involved and avoid heartbreaking situations like miscarriage. However, we should take into account the circumstances of each study and analyse the merits of their findings. Some researchers may have predetermined ideas that they wish to portray through their data and that is something we should be wary of.
FYI: recent article. Women with preterm premature rupture of the membranes do not benefit from weekly progesterone
http://www.sciencedirect.com/science/article/pii/S0002937810010252
“data included in the study suggests a higher neonatal death rate (for both home and hospital births) compared to perinatal death rates. This, of course, is not possible as neonatal deaths ought to be included in the perinatal death numbers—therefore the data here are paradoxical in nature.”
Isn’t the definition of “neonatal death” a death occurring in the first month whereas “perinatal death” is death in the first week? If so, the neonatal numbers would be higher than or equal to the perinatal numbers and this isn’t paradoxical at all.
Another excellent prenatal yoga teacher program is Karen Prior’s Mamaste Yoga!
@Carla Harless Yes, she does have a good program. It was one of the ones I looked into when I was looking to take my prenatal teacher training.
Useful to know. Thanks for posting.
Not really interested in Yoga…but exercise is nice.
[...] Part 1 we talked about how to help your client choose a prenatal yoga class; in Part 2, we will look at [...]
I have taken yoga classes and weight training classes when pregnant, and I really think that the weight training helped me more than the yoga. Maybe it’s just because I’m not as into yoga. I think that learning to relax while lifting weights and working all of those muscles really helped me have a fast and relaxed first birth experience. I’m sure the yoga didn’t hurt, though!
Thank you for talking about Yoga and Lamaze together. They are so complementary. I have only been practicing faithfully for a year myself but have had almost a complete relief from two years of joint pain so I am personally convinced about the benefits of Yoga. These articles gave me some resources and some ideas for incorporating yoga principles with Lamaze principles. I hope as my childbirth business expands I am able to offer my clients prenatal yoga as well. I will guide some of my wonderful yoga instructors to your recommendations for prenatal certification.
Yoga classes should include asana (physical postures) that are weight bearing. Warrior (standing lunges) are weight bearing, Downward Dog, bears weight on your hands, etc. So, a good prenatal yoga class should include all – physical, breathing and meditation/relaxation.
Strength training is very helpful as well, pregnant or not.
Ah, I didn’t recommend the programs above. I apologize if my intentions were unclear. I gave them as examples of the variety of duration and quality of programs that are out there. An online at home program is, in my opinion, totally inappropriate and vastly insufficient. There’s no hands on training, with a hands on practice.
A 12 hour weekend program vs. an 85 hr Yoga Alliance program? What’s missing in the 12 hour program? Hours aren’t the only factor, though. Look at the course content too.
To your other points, yes, Yoga and Lamaze are very complimentary. I’m most of the way through a philosphical discourse on the subject on my own blog http://www.shininglightprenatal.com/2011/07/04/integrating-yoga-and-lamaze-how-the-ethical-practice-of-the-yamas-and-niyamas-relate-to-pregnancy-and-childbirth-%E2%80%93-a-bit-of-background/
I kept up my regular yoga practice throughout my last pregnancy and I know it made a difference for me. I strongly recommend yoga practice to my clients and I recommend a few yoga-based breathing exercises to do at home, too.
There is so evidence to support the use of mindbody therapies! If mindbody therapies were a drug, we would be inundated with TV ads about them! Thanks for sharing this info abt yoga and perinatal health.
Of course, the HuffPo quoted me out of context. I am the LAST person on earth that believes breastfeeding breasts = OK whereas sexual breasts = not OK.
I think ALL breasts are delightful! Please know this. I would ALSO love for us to get to a place of acceptance in society where breastfeeding could be looked at, just like sex, as something that simply feels good. ♥
Did you mean “A hefty dose” in the Editor’s Note?
Thank you for finding the typo.
[...] is the original: breastfeeding – Science & Sensibility Tags: baby, children, deena-blumenfeld, editor, nursing-in-public, quote, sensibility, social-media [...]
Hey Star, I’m a childbirth educator, and we talk about sex in my classes. Well, mostly I talk about this, with some laughter from the moms and birth partners.
Not so much about sex and breastfeeding but generally about how the sex will come back, then I pull out a little bottle of astroglide and share how this might help when the parents are ready later!
With breastfeeding I try to listen for any concerns they might have and address them. We only do about 45 minutes in my classes, though, probably much better for the mom are conversations one on one with a counselor.
Obviously partners are in my classes, and I share that it’s their support that will really make a difference to the mom — keeping the mom fed, drinks a lot of water, and trying to make sure the mom sleeps as often as possible in the first few days and weeks. (Sleep when the baby sleeps, right? Mom staying in pajamas throughout the day so people don’t feel comfy overstaying their welcome.)
And it’s interesting, perhaps like breastfeeding, childbirth ed classes really look at birth from a physiological and/or medical process (depending on the parent’s approach), not from a sexual process. We focus on the reproduction part of it, not the sexual/intimate so much. Of course, the moms and partners are paying for the class to help them through the reproduction part of it; the sexual part they already have down pat! But letting people know about future sex things is also important in classes, as it is with breastfeeding help.
Neat topic for Valentine’s Day — thanks!
There is an interesting future discussion in here about how we women define ourselves pre and post delivery. Motherhood should not come at the exclusion of who and what we were before. Because so many people/sources depict the two as exclusively different many rebel against the traditional depiction of motherhood. A healthy motherhood does not come at the expense of our own health, our relationships/marriage, it is a balancing act where our whole self is the anchor on which the other pieces are placed. Women can be both “hot” and dowdy when they are mothers, most of it comes from their interior sense of self and their integration of their many selves. How they carry themselves not whether they have a baby on the hip or breast or not.
Sarah ~ You are absolutely right. Taking a holistic view of the self both before we become mothers and after is one of the keys to making it work for ourselves. If we only define ourselves by our job, or by “Owen’s mother”, then we neglect our core being. Our true self lies within and she is all, and one, and none at the same time.
I give my yoga students the mantra “I am” and I tell them to add no qualifiers to that. “I am” is the whole and it is enough. When we define ourselves, we limit ourselves.
Sat Nam (Truth is my identity)
[...] are training parents to follow the machine and not that of the actual baby. Reminds me a bit of EFM during labor. We hear stories of both support partners and medical staff who pay more attention to the [...]
Astonishing! Your comments are on target. Offering a product like this, especially to vulnerable first-time parents, most of whom have been raised in this ever-changing technology culture, will do nothing but undermine the development of parental-infant bonding in many parents.
Over the years, my Lamaze classes have dealt more and more with trust in one’s body as well as the processes set forth beginning in pregnancy that culminate in building confidence as parents. This product, used by some parents who understand this, might choose to use this product to double check and confirm decisions. Others (and this may mean “most”) will be as reliant on the technology as they are on their phones during class. Brave New World (read it if you have not done so)seems to be on its way.
This is so shocking and insane. I have so many disgusted thoughts about this “invention” but am rendered speechless.
Hi,
Yoga is good for better pregnancy…
Thanks for sharing..
Regards.
I have a feeling that, like many other technologies (especially in pregnancy and labor monitoring), this technology won’t bring parents the desired peace of mind but on the contrary will undermine their confidence in their abilities and parental instincts.
As someone who works in the field of Medical devices, I think there’s so much we can do to help people while using advanced technology, and yet in some cases technology can just be a disturbance. We should take all those talented people working on silly devices and those who funded them and concentrate on more helpful solutions that solve real problems (SIDS, for example.)
I would never buy something like this. All of your other (very good) observations aside, it takes away the beauty of being a mother– holding your child close and listening to what their bodies tell you. We have enough that interferes with this bond already, starting with your very first prenatal tests!
Wow! It was exciting to see me resurrected from the dead! I’m the Betsy Adrian who wrote the excerpt. (I am happy to report that my daughter delivered her baby with a CNM in a hospital and avoided a c-section because the CNM knew what she was doing.) I have a hard time with the fact that nothing has changed for the better in 30 years; in fact things are worse. I wish I could be more encouraging. I think natural childbirth will continue to be a “fringe” activity and childbirth will continue to be more & more medicalized and interventionist. At least 30 years ago we didn’t see a lot of c-sections scheduled for convenience and now it is an accepted practice. I also have seen very little interest in my daughter’s generation in natural childbirth. Enough rambling. Keep up the good work. There are people who still believe that what you do is worthwhile.
Others have noticed this “discrepancy”, please see
http://lactationnarration.com/index.php/2012/02/breastfeeding-beyond-infancy-in-the-new-aap-statement/
I don’t think it is an oversight.
Hi Lisa! This article is so concise and informative. I work with mothers with perinatal mental illnesses. I struggle to find the balance between infant health and mom’s capacity to care for the infant and herself. So many women feel guilty and traumatized as they wean for their own reasons. I’d love to have a conversation on this, love any thoughts on this, thanks, Kathy
Thank you for the comment Kathy! There are many women who share these feelings of guilt, I agree. In my personal experience I have even heard women feel as if they are “being bullied” into breastfeeding their infants. There is something so wrong with this situation. Perhaps it is in the delivery of the information. What can we, as educators and careproviders, do to share information on breastfeeding with expectant and new mothers without coming across as “bullying” or ‘forcing breastfeeding’? Let’s hear from others!
I gave birth to my baby at 29w after developing severe pre-e. I was committed to breastfeeding, and even more so after I learned that breastmilk provides protection against NEC. I really appreciated being able to provide milk for my baby and eventually to breastfeed her.
I worked with several LCs and had a real range of experiences. The worst was being given a pat lecture about Breast is Best while crying because I was afraid my baby would die. LC entered the hospital room while I was crying, gave her lecture, and exited. I often felt in those first few days after the birth, which had been very complicated, that the advice I received to pump every 2 or 3 hrs did not take into account that I was a very sick woman in a very stressful situation. In some cases I felt that the LCs did not see me as a person with individual needs, but just as a vessel.
The hospital where I gave birth is an urban teaching hospital in a high poverty area with low rates of breastfeeding. I suspect that the LCs adopted harsh attitudes with mother’s out of frustration, and because they felt they had to apply some force to get women to breast feed. Their attitude was similar to attitudes I had encountered as a young woman seeking reproductive services-docs were so afraid that young women would be non-compliant that they really pushed and could be very negative.
I did work with one wonderful LC who spent literal hours in the NICU with my daughter and I. She was persistent while also being gentle and helpful, and she made sure that we were securely breastfeeding before my daughter left the hospital. I am very thankful for her help.
Breastmilk is important, but respect and compassion for individuals is even more important. Having a preemie is an incredibly hard experience, and if preemies need special care, preemie moms (many of whom already experience guilt, PPD, and PTSD) need extra care from all of their health care providers.
Beautifully written Mary, thank you. You have some very good points for all those that work with preterm infants and parents.
Thank you for this valuable informtion. I hope we et a milk bank soon is PA.
hi , i have just been told that i may have endometriosis in my c-scection scar, they have told me that a historectomy is the best option , i feel a little bit unsure as the consultant is not sure if it is that or not, help i am not sure what to do any sugestions
It is of no consequence to me which childbirth education class she takes (if any) but it really rubs me the wrong way to see her discredit a reputable organization that really holds the protection of normal birth and improving the outcome for mothers and babies so near and dear to their heart. Women will see this beautifully inaccurate woman “psh” childbirth education and perpetuate the vicious cycle of the blind leading the blind. Needless to say I’m less than thrilled.
I will say that her naivete is incredible and very characteristic of a first time mom. That said, I wish her well and hope her labor and delivery is everything is hopes for and more.
For further discussion on “Lamaze breathing” and how & why Lamaze has migrated away from prescribing particular breathing methods, view this S&S post: http://www.scienceandsensibility.org/?p=2688
@sam kelly
The case reports and series all reported removing the endometriotic tissue surgically, not hysterectomy. I think your best bet is to get a second opinion from someone not connected with the doctor who is recommending hysterectomy, that is, not in the same office or recommended by this doctor. That way, the new doctor will feel less uncomfortable with disagreeing with the first doctor, and you can feel more confident of the opinion if the new doctor agrees. As for the content of the discussion, in order to make an informed decision, you need to know the benefits and potential harms of all your options, including doing nothing. You may want to get this information from your current doctor as well as the one giving you a second opinion.