Friday Five (#47)

My baby turns five this weekend! She did not smile at us for the first 4 months of her life. We literally didn’t think she could smile! But she has made up ground since and we are blessed to celebrate another year with her….

Are your ready for a packed Five?!

Fasten your seatbelts…this one is full.of.resources!

1. A handy provider reference for COVID-19 infections in pregnancy.

I shared this one a while back, but it’s an important one – so it’s a repost! This is an easy way to talk to women about what the evidence tells us. QR codes included in case someone wants to check out the articles themselves!


2. The flu shot reduces a pregnant woman’s risk of getting hospitalized by 40%.


This study, published in the Clinical Infectious Diseases journal, found a couple of key things:

  • 80% of pregnancies overlap with the flu season
  • The flu vaccine is equally protective across all thee trimesters in pregnancy
  • The flu vaccine offered equal protection to women with medical problems and women without medical problems

Most seasons, only about 1/2 of pregnant women choose to get the flu vaccine. The CDC runs a campaign to improve vaccination rates:

3. This handout from the Royal College of Obstetricians & Gynaecologists (RCOG) on caring for third and forth degree lacerations in childbirth.

This is a point of passion for me for a few reasons. Sometimes these lacerations are very traumatic and sometimes they heal very well with no long term issues. It’s very hard to know when you discharge someone what their healing is going to be like. It’s also hard to predict what their future birth plan may be!

Regardless, I find that most of the time there isn’t good education provided to the mama in the hospital about the type of laceration she had and how to care for it. This resource is one of my favorites that I’ve recently stumbled upon and I’ve found it’s a good one to send the patient home with. It offers immediate laceration care as well as counseling for future birth considerations.


4. AWHONN’s updated Position Statement: Breastfeeding and the Use of of Human Milk


Most women stay in the hospital for a few days around their birth and postpartum courses. It’s an average of 2 to 3 nurses at minimum that help care for that mama and her family. That’s hours and hours of opportunity to discuss breastfeeding benefits. Breastfeeding discussions should start in the clinic, but they can also start on admission to the unit, while the patient is in labor, and of course, during postpartum courses, discharge conversations and at follow up appointments.

For nurses on labor and delivery, this is a nice summary of the benefits of breastfeeding:

  • Children that are breastfed have a reduction in mortality (risk of death) and morbidity (risk of disease).
  • Breastfeeding is associated with lower rates of gastroenteritis, diarrheal diseases, SIDS (sudden infant death syndrome), ear infection, respiratory infection and childhood leukemias.
  • Breastfeeding is associated with a reduced incidence of childhood obesity and diabetes (type 1 and 2).
  • Breastfeeding during painful procedures (childhood vaccinations) helps to provide pain relief to infants.

Breastfeeding offer benefits to women as well:

  • In the postpartum period, breastfeeding helps to reduce the size of the uterus and the amount of blood loss a woman may have. This is from the oxytocin surges initiated each time the baby latches to the breast.
  • Milk production utilizes a woman’s fat stores and helps a mama to lose weight postpartum.
  • Breastfeeding also reduces a woman’s risk of breast and ovarian cancer, and rheumatoid arthritis.

There is a greater good too; breastfeeding improves public health:

  • Breastfeeding saves money for communities, the government, employers and families.
  • Employers that support breastfeeding have less turnover and save money from recruitment and retention.
  • Breastfeeding families save money on formula.
  • Breastfeeding is environment friendly! It generates no waste and is a renewable resource! (Association of Women’s Health, Obstetric, and Neonatal Nurses, 2021).

5. A new fact sheet from MotherToBaby about the COVID-19 Vaccines.


I love this new handout for one reason: the references. Look at them yourself here. I’ve seen some other handouts that just have a few references, but this resource has a nice, robust amount of evidence backing it…and, you can access it all online. Win/win.

Other goodies…

This updated post from La Leche League: Breastfeeding as Described by LLLI.

A new resource to put in your back pocket: Pregnant@Work. From the site: “This online resource center provides tools and educational materials for pregnant and breastfeeding workers, the healthcare professionals who treat them, and the attorneys who represent them. It also has useful materials for companieshuman resources professionals, and management attorneys that can assist in navigating the many legal and practical considerations around pregnancy and breastfeeding accommodations.”

A new blog to recommend: The author is working on a new book and I had the privilege to speak with her about the project, mamahood, productivity….all the things I could talk for hours about! Check it out!

Another new breastfeeding website to recommend: This is Indiana’s Mothers’ Milk Bank but they have an informative site, blog and newsletter for anyone in the state or anyone wanting to follow the initiative.

Fact sheets from the United States Breastfeeding Committee. You have to download them, but they are easy to read, factual and overall good handouts. This would be a good one to keep in a clinic, a waiting area or even a labor and delivery triage (women spend hours there too!).

The Safer Childbirth Cities initiative is a community-based organization in cities across the United States to help improve maternal health outcomes that matter most in their cities. I did not know about this site – but went down quite a rabbit hole looking up the different initiatives across the states. It made me really proud to see that these cities and the communities in them are advocating for change. See if your city is on the list:

Atlanta, Georgia
Austin, Texas
Baltimore, Maryland
Brooklyn, New York
Camden, New Jersey
Chicago, Illinois
Columbus, Ohio
Detroit, Michigan
Jackson, Mississippi
New Orleans, Louisiana
Newark, New Jersey
Norfolk, Virginia
Philadelphia, Pennsylvania
Pittsburg, Pennsylvania
San Francisco, California
St. Louis, Missouri – here and here
Tampa, Florida
Trenton, New Jersey
Tulsa, Oklahoma
Washington, D.C.

Also check out an updated list of COVID-19 Resources for Maternal and Infant Health from the CMQCC and CPQCC. Right at the top of the list is an update to allow two visitors for support in labor. A doula is also encouraged in addition to the support person!

Last thing, from the CDC, this report that noted that pregnant women with COVID-19 are at increased risk for stillbirth when compared to pregnant women without COVID-19. The overall relative risk was 1.9 times more likely – but the report also notes that the risk was 1.47 times higher pre-Delta variant and 4.04 times higher with the Delta variant.

The report adds to existing evidence that COVID-19 vaccination before or during pregnancy could be critical to a reduction in stillbirth.

May you be safe wherever you are this holiday seasons!



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1 year ago on the blog…Happy One Year Anniversary to A Midwife Nation!


Association of Women’s Health, Obstetric and Neonatal Nurses. (2021). Breastfeeding and the use of human milk. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 50(5), e1-e5. doi: 10.1016/j.jogn.2021.06.006

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