Monday, December 29, 2008

Common Chemicals May Delay Pregnancy

Another recently-published study has found a link between exposure to common chemicals and the time it takes a woman to conceive as well as birth defects and growth restriction in fetuses. It's yet another example of how the expansion of technological options can have unintended side effects on our species.

The most disturbing fact is that the chemicals were known toxins in the process of being phased out. While it's encouraging that they are being removed from products, the reality is that the damage has been done; while they will no longer be present in newly-manufactured items, there presence will linger in landfills, water supplies, and our bodies for decades to come.


We must remember that our actions today force the outcomes of tomorrow. More due diligence is needed on the safety of such technologies before they are used to prevent this seemingly never-ending cycle of self-destruction through industrialization.

Monday, December 22, 2008

Understanding the Dangers of Cesarean Birth: Making Informed Decisions



Understanding the Dangers of Cesarean Birth: Making Informed Decisions, a new book by Nicette Jukelevics, MA, ICCE of the wonderful resource on vaginal birth after cesarean section, VBAC.com has just been published.


You can learn more about the book and view the table of contents at: http://www.dangersofcesareanbirth.com


I haven't had a chance to read it yet, but I'm certain it will move onto my list of recommended resources.


Buy your copy from Amazon using GoodSearch and the vendor will donate to the Coalition for Improving Maternity Services (CIMS). Go to www.goodsearch.com/goodshop.aspx, choose CIMS as your charity, then choose Amazon and enter Dangers of Cesarean Birth in the Amazon search bar.


This is a timely book I'm sure will help empower and inform mothers to help stem the tide of ever-increasing c-sections without improved outcomes for mothers and babies.


Please pass this along to all the mothers in your life.


Wednesday, December 10, 2008

New Research on Predicting Pre-eclampsia

Researchers at the University of Bristol have conducted a new study which may help predict which mothers are at risk of later developing pre-eclampsia.

Friday, December 5, 2008

Flaxseed Oil and Risk of Pre-term Birth


New study finds link between flaxseed oil consumption in pregnancy and pre-term birth



An interesting read....

Sunday, November 30, 2008

How Different They Are...


Yesterday, I ran across this article, which details the story of a UK mother with a history of precipitous labor (labor lasting less than 3 hours), who chose a homebirth (which nearly became an unassisted birth) with her last child to avoid giving birth en route to the hospital.


She and I share commonality in that both my labors were also precipitous. My first was born in 3 hours and my second in a mere 45 minutes.


As I read further, I was struck by a seemingly small detail, but one that truly crystallizes the differences between the US and UK maternity systems:

"After Charlotte was born doctors had recommended that Hazel have a home birth if she ever fell pregnant again..."



Ummm, did I read that correctly?



In the US, homebirth would never be suggested as the solution to precipitous labor. I can personally attest to the one-and-only US answer: "medically necessary" induction.


In my case, this would mean inducing between 36-37 weeks, as both my children were also born before 38 weeks.


So, despite the fact that precipitous labor at term is typically moving so quickly because it is completely uncomplicated, because everything is going right, I would be forced, not only to undergo a decidedly unnecessary induction with all the added risks it entails, but also at the additional risk of delivering a pre-term infant, and all in the name of "preventing complications".


This is a perfect example of how overmedicalized the US system is: instead of letting labor progress normally on its own, the desire for a false sense of control makes modern obstetricians believe they must save me from myself, that only by their aggressive intervention could I be saved from the risk of birthing in my own time, in my own home.


In all probability, my next birth will be unassisted, not as an active choice, but due to the lack of one.



My choices are:


1. Plan a hospital birth

      This means accepting an induction and all its ancillary interventions between 36-37 weeks. There are no birth centers in my state, so that is not an option, although even in a birth center, induction would be my only option. I have interviewed all the insurance-covered OBs in my area and this is the consensus, take it or leave it.



2. Plan a midwife-assisted homebirth

      Due to the lack of support for midwifery care from the medical maternity model, the nearest midwife to my home is still over an hour away. Were my next birth to go as quickly as my second, it's highly unlikely she would arrive before the baby did. Even if we called from the very first contraction, I doubt there would be enough time for her to get to our house.




So, what to do? Most likely, I will choose a midwife, paying four times as much for her care (since my insurance won't cover midwifery care), all the while knowing she probably won't be present for the birth.



While many would baulk at the thought of an unassisted birth, I accept that, whether I want it or not, this may well be the reality of birthing again. As such, I don't spend time worrying about this fact; rather, I can focus on preparing everything needed to birth as safely as possible at home.


If modern obstetrics truly cared about making birth as safe as possible, then their focus would be on practicing evidence-based medicine and recognizing when intervention was truly necessary. Thus, the midwifery model of care would be the standard, so that women such as I could birth safely with a skilled attendant present no matter what place of birth was chosen.

Friday, November 28, 2008

Mother-Friendly Childbirth Forum to Gather in San Diego


The Coalition for Improving Maternity Services' (CIMS) 2009 Mother-Friendly Childbirth Forum and Annual Meeting will be held March 5-7, in San Diego, California. The program includes 24 sessions that will cover a broad range of issues affecting childbearing women.

The 2009 CIMS Forum will cover topics ranging from "Racial and Ethnic Disparities in Birth Outcomes," to the findings of a new national report, "New Mothers Speak Out," on the physical and mental health challenges faced by new mothers, to "The Case Against Elective Repeat Cesarean Surgery," to "Why Transparency in Maternity Care Matters."


This is sure to be an eye-opening event and one that is truly crucial to affecting change through the modern maternity machine. The key to accomplishing true change in the system is through widespread public awareness, not only of the shortcomings of the current system, but of simple ways it could be changed for the benefit of mothers and babies.

The full press release is available here.

Sunday, November 16, 2008

The Pitfalls of Impatience


A new study published in the November, 2008 issue of Obstetrics and Gynecology, conducted by researchers at the University of California, San Francisco, found that over 130,000 cesareans could be avoided each year by simply waiting an extra two hours for labor to progress normally.


The study focused on the all-too-common "failure to progress" c-section. The study was longitudinal over 1991-2001 and examined outcomes for 1,014 women having their first child at the UCSF.


Current ACOG guidelines state that physicians should wait two hours once an active labor arrest, or a period of time when dilation and effacement have ceased, before moving to a c-section. However, the article states that while this is the standard of care, many physicians currently ignore the guideline and move straight to an avoidable, unnecesarean.



Currently, 1/3 of all c-sections performed each year are for "failure to progress".



The study also highlights the dangers of a primary c-section, which are so often overlooked and were well outlined by the head author:


"Cesarean delivery is associated with significantly increased risk of maternal hemorrhage, requiring a blood transfusion, and postpartum infection," Caughey said. "After a cesarean, women also have a higher risk in future pregnancies of experiencing abnormal placental location, surgical complications, and uterine rupture."


Results of the study also found that women who had c-sections had increased rates of postpartum hemorrhage, chorioamnionitis infections and endomyometritis infections.


However, no significant difference in the health outcomes of the infants was found.


The most refreshing factor about this study is that ultimately, it highlights the dangers of primary and repeat c-sections as well as highlighting the role of physician non-compliance with the outlined standard of care.


Ultimately, the study shows that if physicians follow evidence-based guidelines in their practice, maternal outcomes are improved.


Despite the fact that this is a new study, this is not new information. The two hour wait time was already the standard of care when this study was undertaken. The real issue is getting physicians to respect the evidence and stop rushing to a c-section at the earliest convenience.


I have to wonder what will have to happen before physicians start using evidence-based practice in maternity care.


Despite study after study extolling the pitfalls of procedures such as episiotomy, lithotomy position, EFM, failure to progress c-section, restricted movement and arbitrary time limits on labor, these harmful practices are still standard across much of the US.


Perhaps a punitive approach would work: fine physicians for each non evidence-based procedure: $500 for an episiotomy, $1000 for EFM, $3000 for each unnecesarean.


That, I think, would be an effective approach at gaining adherence to evidence-based medicine and focus on maximizing reimbursement for quality care, not convenience.

Friday, November 14, 2008

The MEAC Needs Your Help


Feel free to pass this along and support midwifery across the US. Donations are also tax-deductible.


October 2008

Dear Friend of the Allied Midwifery Organizations,

MEAC needs our help!

MEAC is the Midwifery Education Accreditation Council. MEAC promotes excellence in midwifery education by supporting and accrediting midwifery schools around the country that prepare midwives for national certification as CPMs. MEAC is doing exciting, groundbreaking, and vital work for our midwifery movement. Just this month, the Milbank Memorial Fund, a non-partisan institute devoted to health policy analysis, issued a new report titled, “Evidence-Based Maternity Care: What It Is and What It Can Achieve”. The report cites data from the landmark study of CPMs published in 2005 and concludes:


The low CPM rates of intervention are benchmarks for what the majority of childbearing women and babies who are in good health might achieve.


MEAC currently accredits eight free-standing institutions and two programs that reside within universities, providing excellent midwifery education for more than 500 matriculating students.


Why does MEAC need our help now?


This year, the U. S. Secretary of Education deferred a decision to extend recognition of MEAC, requesting that MEAC provide evidence of a stronger financial and volunteer base. It is ESSENTIAL that MEAC satisfies the requirements to continue its recognition by the USED. This appeal to you hopes to accomplish two things:


1. Increase the capacity of MEAC’s Reserve Fund to cover one year’s operating budget ($120,000).

2. Demonstrate to the USED that MEAC has a strong base of support that can be called upon to respond swiftly and effectively in a time of need.


Please help us in this one-time capital campaign. We have come so far in the last decade. We can’t let it slip away. Your support is crucial and so much appreciated at this time! Please give generously. Large donations of $500-$1,000 will provide significant support. Smaller donations will help, step-by-step, to achieve this goal. We can do this together- it is an investment in our future!


Sincerely Yours,

The Leadership of the Allied Midwifery Organizations


*Donations to MEAC are tax deductible!
Make checks payable to MEAC, POB 984, LaConner, WA 98257,
http://www.meacschools.org

Sunday, November 9, 2008

Ten Americans



This will give you chills...




Disturbing to say the least.


In this same vein, the Primal Health Research Centre, led by Dr. Michel Odent, is exploring the correlations between the 'primal period' (fetal life, perinatal period and year following birth) and health and personality traits in later life.


On their site, PrimalHealthResearch.com they have compiled the Primal Health Research Databank, which includes studies that focus on the primal period of development. It's a wonderful resource for evidence-based information.


Hopefully, the efforts of such organizations as the Environmental Working Group and the Primal Health Research Centre will affect system-wide change for both our environment...and our babies.

Friday, October 24, 2008

Petition for Preemies



The March of Dimes is sponsoring a Petition for Preemies as part of this October's Prematurity Awareness Month.


Prematurity is the leading cause of infant mortality in the US. The petition consists of 4 calls-to-action:


  • Increasing federal government support of research and data collection on prematurity, to discover the causes of prematurity, to test prevention methods, to improve outcomes and treatment options for premature infants, and to better understand the factors in premature birth

  • Expanding access to quality healthcare and devoting more resources to smoking cessation programs

  • Urging hospitals and physicians to voluntarily assess c-sections and inductions before 39 weeks to examine adherence to professional guidelines

  • Calling on businesses to support mother and infant health by respecting the March of Dimes' 14 recommendations.




To date, they have acquired 67961 signatures - what number is yours?

Thursday, October 23, 2008

Antibiotics for Preterm Labor Carry Long-Term Risk for Babies



New research shows that antibiotics given during apparent premature labor, without ruptured membranes or detectable infection, provide no benefit and may cause long-term harm to children

Cerebral palsy was present nearly twice as much in children at age 7 whose mothers received erythromycin during spontaneous preterm labor. An increase in risks was also seen with a combination of amoxicillin and clavulanate (co-amoxiclav), although it was lower. Among 1,611 children exposed in utero, 3.3% had cerebral palsy at age 7, compared with 1.7% of children in the control group or those exposed to co-amoxiclav alone.

In addition, the children were also at increased risk of functional impairment, which includes abnormalities such as difficulties with learning, walking, eyesight and other more extensive disabilities. 42.3% of children in the erythromycin group demonstrated some type of functional impairment.

For women with ruptured membranes but no signs of clinical infection, antibiotics neither improved nor increased risks.

The researchers calculated that one child would experience harm for every 64 mothers treated with erythromycin while 1 child would experience harm for every 79 mothers who received co-amoxiclav alone.

In the U.S., guidelines from ACOG recommend a combination of amoxicillin and erythromycin for women with preterm membrane rupture but neither the ACOG nor RCOG guidelines in England address the use of antibiotics for women in preterm labor whose membranes have not ruptured.

In response to the new study, Alison Bedford Russell, M.B.B.S., B.Sc., of Warwick Medical School, and P.J. Steer, M.D., of Imperial College London stated:

"The lessons to be learned seem clear: contrary to popular opinion ('might as well give them, they don't do any harm'), antibiotics are not risk free,".



The moral of the story: interventions should be used with discretion and follow the purpose to which research has shown them to be effective. More isn't always better.

Wednesday, October 22, 2008

Birth Summit To Be Held In Chicago


A Historic Birth Summit will be held in Chicago on November 8, 2008 at the O'Hare Hilton, in the hometown of the American Medical Association.


This historical summit was called in response to the ACOG/AMA joint proclamation (resolution 205 A-08), which sought to draft model legislation to outlaw homebirth and purported that "the safest setting for labor, delivery, and the immediate post-partum period is in the hospital, or a birthing center within a hospital complex, that meets standards jointly outlined by the American Academy of Pediatrics (AAP) and ACOG, or in a freestanding birthing center that meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers".


The summit will bring together birth activists, nurses, physicians, midwives, childbirth educators, doulas, and lactation consultants to will set the evidence-based record straight regarding midwifery care and childbirth in hospital settings in the US.


Despite their strong stand and numerous requests for the reasoning behind their proclamation, the ACOG/AMA could not cite research to support their opinion that hospitals are the safest setting for childbirth, because there is simply no research to support their stance.


At the conclusion of the summit, a joint evidence-based announcement will be made to refute the AMA/ACOG proclamation, highlight its inaccuracies, and the impact that enacting such legislation would have on an expectant mother’s right to choose her caregiver and place of birth.


All I can say is, give 'em hell....

Tuesday, October 21, 2008

Impact of Initial Miscarriage on Future Pregnancies




A new study from the University of Aberdeen studied the impact that an initial miscarriage can have on a woman's next pregnancy.


Results revealed that a woman is 3.3 times as likely to have preeclampsia and 1.5 times as likely to have a premature baby. Women who previously had a miscarriage were 1.7 times as likely to experience bleeding or other signs of threatened miscarriage and 1.3 times as likely to experience bleeding later than 24 weeks gestation.


In a study of 33,000 women published in the British Journal of Obstetrics and Gynaecology, women who suffered a single miscarriage experienced nearly double the rate of inductions and 6 times as many instrumental deliveries with forceps or vacuum extraction.


Preterm birth after 34 weeks and birthweight less than 2500 grams was 1.6 times as likely.


Professor Philip Steer, BJOG editor-in-chief stated:


"The findings from this research are helpful to healthcare professionals caring for pregnant women.

"They provide us with an idea of the complications that may arise as a result of a previous miscarriage. This will help doctors in the management of the subsequent pregnancy."



One factor not assessed was the span of time between pregnancies, which does not decrease substantially until 1.5-2 years and increases with less than 6 months between pregnancies.


The moral of the story...don't let a care provider dismiss your concerns if you've suffered a past miscarriage. Most women go on to have successful pregnancies, but a past history of miscarriage can increase the risks with subsequent pregnancies.

Monday, October 20, 2008

Birth Trauma Impacts Breastfeeding




A new study shows that up to 1/3 of women reported a traumatic childbirth experience, with up to 9% reportedly experiencing Post Traumatic Stress Disorder (PTSD), which can cause women to limit future reproduction, damage their ability to bond with their babies, and leave them permanently psychologically scarred.


Results showed that women who suffered a traumatic birth experience went down two paths regarding breastfeeding: they either embraced it as a way to "prove" themselves as a good mother after a difficult birth and steeling their resolve to breastfeed, or for others, it caused intrusive flashbacks, detachment, and physical pain that ultimately caused them to cease breastfeeding.


The authors concluded that:

...intensive one-on-one support for traumatized mothers may be necessary to help them establish breastfeeding. Sensitivity and awareness by medical professionals of the traumatized mother’s needs may also be helpful.



It was also suggested that healthcare providers be more aware to the signs of a traumatic birth, including temporary amnesia, remaining detached and poor eye contact/a dazed look.


The research study: “Impact of Birth Trauma on Breastfeeding – A Tale of Two Pathways,” appears in the July/August 2008 issue of Nursing Research and was co-authored by Cheryl Tatano Beck, Board of Trustees Distinguished Professor of Nursing and Sue Watson, chairperson of the Trauma and Birth Stress charitable trust.

Sunday, October 19, 2008

New Research on Maternal Diet and Obesity in Babies




High Fat Maternal Diet Linked to Obesity in Babies


In an animal study from the University of Cincinnati and the Medical College of Georgia, researchers found that mice fed high-fat were more likely to have larger-than-average babies, which is a risk factor for being overweight or obese later in life.


They found that a high-fat causes the placenta to go into "overdrive" and sends too many nutrients to the baby developing in utero.


On a positive note, they also theorized that putting women on a high-fat diet may help to reduce the number of low birth weight babies.


In either case, this new research yet again highlights the importance of nutrition during pregnancy and the long-term effects it can have, for better or for worse, on your baby's life. Sadly, most obstetricians pay lip service to providing expectant women with detailed nutritional guidance during their pregnancies. Increased attention to nutrition could be the catalyst to preventing life-long complications for children and subsiding the obesity epidemic in many countries.

Saturday, October 18, 2008

Meta-analysis Shows VBAC Improves Outcomes over Repeat Elective Cesarean Section



Maternal Morbidity following a Trial of Labor after Cesarean Section vs Elective Repeat Cesarean Delivery: a Systematic Review with Meta-analysis


A new meta-analysis showed that while VBAC carries a greater, although still low risk (1.3%) of uterine rupture/dehiscence than repeat elective cesarean section, the risk is counterbalanced by lowered rates of maternal morbidity, uterine rupture/dehiscence and hysterectomy with successful VBACs.


The research also showed that the majority of women who attempted VBAC were successful (73%).


I have to wonder how much higher that number would be if women had true access to an evidence-based approach to childbirth without unnecessary interventions, and truely supportive providers.


Regardless, the evidence continues to overwhelm with support that VBAC should be a viable option in the majority of cases and that repeat elective cesarean section carries risks greater than or equal to VBAC.


It's time to lay the "once a c-section, always a c-section" myth to rest. Period.

Friday, October 17, 2008

Hidden Risks of Down Syndrome Screening

Down Syndrome Screening Causes 2 Miscarriages for Every 3 Cases Detected


New research to be published in the Down's Syndrome Research and Practice Journal found that the miscarriage risk from amniocentesis and chorionic villus sampling (CVS) carried a 1-2% risk of miscarriage of typically developing infants.


The tests are usually only offered to women considered at risk; however due to the wide initial screening threshold, over 95% of women determined to be at risk will go on to have the tests and find that the results are negative.


The mindset behind the screenings is to "help women make informed decisions about their pregnancies". The research also called the skill and experience of those administering the procedures into question.


Before consenting to these or other procedures, ask yourself if knowing about the condition would change your plan of action for the pregnancy. If the answer is no, then consider refusing such screenings.


Many women choose the screenings to give themselves time to mentally and emotionally prepare to care for a child with special needs. However, due to false positives, some families are told their infants will have such conditions only to find that after months on end of worry, their fears were unfounded.


The moral of the story is to make informed decisions. If you know the risks of the screenings outweigh the benefits to your family, then don't hesitate to refuse them. You are your child's first advocate. Parenting begins with the decisions you make in pregnancy.


Choose well, choose wisely.

Saturday, October 11, 2008

Upcoming Special on Out-of-Hospital Birth

I received the query below for an upcoming special on out-of-hospital birth. If you can help or know someone who would be interested in sharing their story, please spread the word:


My name is Zach Marion and I work at Video Arts Studios in Fargo, ND. We produced the series House of Babies for the Discovery Health Network. Under the guidance of master midwife, Sheri Daniels, at the Miami Maternity Center, the show follows couples during their pregnancy and ends with the delivery of their baby. It was very instrumental in raising awareness about non-clinical birthing practices on a national level.



Recently we have been approached to create a one-hour special on unique birthing practices worldwide. We are looking for families that would like to share their story on camera from pregnancy to delivery. Ideal candidates are expecting mothers due in and around early January that are planning to give birth outside of a clinic or birth center. This includes home births and beyond. The point of the show is to raise awareness about the alternative birthing options in the U.S. with the help of a midwife. Hopefully, the special creates a healthy dialogue among midwives, doctors, to-be parents, and the general public. Stories that are of particular interest are those that include interesting traditions during pregnancy and unique backdrops during delivery. For example, a Hindu family that wants to deliver outside or a family of hippies that are pursuing a home birth in a tent.



As you can imagine, access is usually the greatest struggle. Our presence at the birth goes nearly unnoticed. This unobtrusive nature was learned through experience gained while producing 26 episodes of House of Babies.

Do any clients spring to mind that might want to be a part of this project? Any and all contact leads are much appreciated. Feel free to contact me by phone with inquiries or information. I am available during weekdays between 8 and 5 CST. Thank you for your time.

Sincerely,
Zach Marion
Video Arts Studios
1440 4th Avenue North
Fargo, ND 58102
(701) 232-3393
zach@videoartsstudios.com

Saturday, October 4, 2008

Dr. Diabolic and the God Complex

Recently, I happened upon a heated discussion (or rant) by a physician [and I do use the term loosely] on the "unfortunate" occurrence of women having a say in their childbirth choices. His post and the comments of fellow physicians crystallize the flaws in our current system and its misogynistic treatment of women.



My response to their litany appears below:



Yes, there is plenty of clinical research going on....but what good is research if OBs don't follow the evidence in their practice.


All of the following procedures/routines have been shown to be at best, unnecessary, and at worst, harmful, to birthing women, yet they are still standard practice for much of the OB community:



  • Episiotomy

  • Pushing in Lithotomy position

  • Cytotec for Induction or PPH

  • Continuous Electronic Fetal Monitoring

  • Routine Induction before 42 wks

  • Manual Cord Traction

  • Early Cord Clamping

  • C-section for "Big Babies"

  • Late Term Ultrasound for Fetal Weight Estimates



to name a very few. I have to wonder how the physicians above can claim to practice "science based medicine" when standard practice is rife with such non-evidence based procedures.


By even referencing the first example of the woman whose baby was "too big to fit" as a defense of their position that women should just shut-up-and-listen-to-everything-the-big-smart-doctor-says, these medical professionals have proven how fallible they truly are.


There is no evidence to support that suspected fetal macrosomia can reliably be diagnosed without a trial of labor [and one that does not have a woman flat down on her back tethered to an IV with an EFM belt strapped to her abdomen]. Furthermore, there is no evidence to support that weight is a predictor of which babies will fit, as the circumference of the head and shoulders is a more accurate indication than weight alone.


As posted above, the indication would have been shoulder dystocia, which most appropriately could have been resolved with use of the Gaskin maneuver (gasp! an evidence-based procedure from midwife Ina May Gaskin), which could have prevented the baby from being born floppy and requiring resuscitation.


But rather than employ evidence-based medicine, the physician in question had a tantrum about the patient delaying/refusing a [non-evidence based] c-section. He did not attempt to employ any other methods to prevent problems from occuring since he had already [inaccurately] determined a c-section to be the fast, easy and sole solution, the only one acceptable to him. Rather than acknowledging his own errors in judgment, he then blamed the patient for wanting a certain "experience" over a healthy baby.


The plain truth is that her motivations most likely did not arise from any desire for a certain experience, but in a desire to escape non evidence-based interventions.


With evidence-based care, she could have had both a positive experience and a healthy baby.


~~~~~~~~~~~~~~~~


Contrary to expecting perfection, it is my realization that doctors and specifically to this discussion, OBs, are mere mortals - as human as the next person - which makes me question their recommendations, just as any good consumer would do.


They are just as prone to make decisions based on their own comfort and agenda as the rest of us. There is no higher standard to which they hold themselves, nor should we. They lie to get want they want and to force an outcome in their best interest, which is something all humans are guilty of at one point or another.



It is this realization, that OBs don't always provide care based on the best interests of the patient [because they are fallible humans by nature] nor that their advice is always based on the evidence, whether intentional or not, which makes me question their judgment and motives when providing maternity care.


Women cannot accept their doctor's advice at face value, which is something doctors should acknowledge and accept of them as consumers. In no other arena would people be expected to take what is said as the gospel truth, infallible and without question.


However, physicians are creating a double standard by arguing their humanity while condemning women for questioning their judgment. These two principles are mutually exclusive. One cannot claim infallibility while professing humanity.



~~~~~~~~~~~~~~~~~~


To address the issue of litigiousness and liability, I can't help but think physicians have spawned this monster. By perpetuating the use of non evidence-based practices [some of which are proven to cause harm], they create complications that wouldn't have presented otherwise, including failure to progress, fetal distress by aggressive induction, PPH by manual cord traction, and the list goes on.


By asserting that women are not capable of fully understanding and making their own healthcare decisions, they are by extension saying that a doctor's judgment is paramount. Thus, any and all bad outcomes would be the doctor's responsibility, as they are claiming women don't have the ability to make these informed decisions.


In actuality, it is the doctor's responsibility to obtain true informed consent from his patients before any and all procedures by explaining the risks and benefits in a way she can understand. If a woman does not understand her options, it is because the doctor has not done his job.


In either case, the physician is responsible, for either taking the decision out of her hands, ingnoring her decision when it conflicts with his own, or denying true access to informed consent so that an informed decision can be made, even one that is contrary to the physican's determination of "doctor knows best".


~~~~~~~~~~~~~~~~~~


Until the system is changed to give the locus of control back to birthing women, we will continue to see this downward spiral in the quality of our maternity care, of excessive infant mortality rates, increasing maternal mortality rates and skyrocketing rates of interventions as standard practice.


For a country that spends in excess of $50 billion per annum on maternity care, more than any other nation in the world, we have pathetic outcomes to show for it.

Thursday, September 4, 2008

New Study on Bonding and Natural Birth

Natural Birth May Aid in Infant Bonding

A new study conducted at Yale looked at the differences in maternal responsiveness to a baby's cry between mothers who gave birth naturally and those who chose an elective c-section and found that mothers who gave birth naturally were more responsive to their newborn's cries.


While the study is far too small to drawn any real conclusions, the results may peak more interest into research in the pitfalls of maternal-request cesarean section. Hopefully, some solid evidence will steer women away from making this decision lightly out of fear of labor or just plain old convenience.

While I don't personally agree with maternal request c-section, I still believe it is a valid choice that women should have, just as we should also have the right to homebirth with the provider of our choice.


What I don't believe is that insurance should have to pay for a maternal request c-section with no medical or emotional indications, since it is shown to increase the risks to both mothers and babies.


Unlike homebirth, which has been proven to be both a safe and cost-effective option, elective c-section can boast no such claims. This study is yet another piece of recent evidence that demonstrates the hidden risks of surgical birth.



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