Birthingway's Biodynamic Resuscitation of the Newborn (BRN)

Neonatal Resuscitation is slightly different than resuscitation of infants, because for the first several minutes of life the new baby responds physically more like a fetus. In addition, the lungs of the newborn are uninflated and fluid-filled. This requires a slight change in the resuscitation procedure. Most resuscitation programs in the United States don't cover neonates, or do so very briefly. The only national certification currently available for neonatal resuscitation is NRP (Neonatal Resuscitation Provider); however, it is intended for use in the hospital and training is mainly available for hospital-based providers. In addition, only current delivery-room hospital staff qualify to be certified as NRP instructors.

To meet the needs of the out-of-hospital care provider, Birthingway created the Biodynamic Resuscitation of the Newborn program. This is our own "home-brew" combining aspects of NRP, overseas resuscitation models, and evidence-based practices. It is similar to other programs in that it is based on a sequence of care provision alternating with assessments and with a progression of care from least to most interventive. However, BRN is unique in several ways:

  • Recognition that the fetal stress response continues through the fetal transition period
  • Delayed cord clamping to optimize lung perfusion and avoid anemia
  • Alternating six-second assessments with 30 seconds of care/action – NRP omits the six-second assessment between the inflation and the first set of ventilation breaths. Because field-based care is provided to newborns who have not been exposed to medications and who are generally low risk, most respond positively to stimulation alone while most of the remainder respond to inflation breaths. A six-second assessment at that point usually results in discontinuing resuscitation, as the baby has responded well.
  • Use of room air for the first 90-seconds/two ventilation cycles of resuscitation.
  • Recognition of the importance of a calm resuscitation environment to minimize neonatal catecholamines.
  • Requires little or no specialized equipment to perform.

Students who complete the program receive certification in Biodynamic Resuscitation of the Newborn (BoRN or BRN). This certification is approved for midwives to meet the neonatal resuscitation requirement to renew licensure in Oregon state and is valid for two years.

As of, April 18th, 2011, BRN meets NARM certification and recertification requirements.

Birthingway offers both an initial and renewal training at different points throughout the year.

Training Term offered Length of the training
Initial BRN Training Winter and Summer Terms 8 hours
Renewal BRN Training Spring and Fall Terms 5 hours

The BRN initial training is for student midwives or midwives who are taking BRN for the first time or who's BRN card has been expired for more than three years from issuance.

The BRN renewal training is for midwives or student midwives who have previously taken BRN and who's BRN certification is going to expire soon. To register for this training, you will need to include a copy of your BRN card with the registration form and payment.