“Wax Paper” is what home birth supporters have taken to calling a metaanalysis that appears in the September issue of the American Journal of Obstetrics and Gynecology. A research method that has come under criticism in the past, a metaanalysis pools together data from several studies, and this one comes to a hotly contested conclusion: that babies are three times more likely to die if born at home, said the study, whose lead author is Joseph Wax, M.D....
...Several researchers and providers are lambasting the study as not only “deeply flawed” but “politically motivated,” the result of “intense medical lobbying.” (See: MOMS legislation introduced to the House last month.) Two independent experts who looked at the study for Time found it “weak and methodologically flawed.” The main criticism of the metaanalysis is its inclusion of old, discredited data that did not distinguish between planned, attended home births and accidentals on the kitchen floor or back seat, which have worse outcomes to be sure. And while the study was presented as being based on “hundreds of thousands of births,” its banner finding, that home birth is “associated with a tripling of the neonatal mortality rate,” is based on just 9,811 home births. And most of those deaths come from said poor data
“Women are not merely participants in this process, we are the process. All women want to have healthy babies.”
Vaginal examination (VE) and assessment of the cervix is currently considered to be the gold standard for assessment of labour progress. It is however inherently imprecise with studies indicating an overall accuracy for determining the diameter of the cervix at between 48-56%. Furthermore, VE's can be unpleasant, intrusive and embarrassing for women, and are associated with the risk of introducing infection. In light of increasing concern world wide about the use of routine interventions in labour it may be time to consider alternative, less intrusive means of assessing progress in labour. The presence of a purple line during labour, seen to rise from the anal margin and extend between the buttocks as labour progresses has been reported. The study described in this paper aimed to assess in what percentage of women in labour a purple line was present, clear and measurable and to determine if any relationship existed between the length of the purple line and cervical dilatation and/or station of the fetal head.
Mom, on the first day of first grade, don't say, "I love you Sweetiepie - have a great first day - I'm so proud of you!" when I'm walking toward my school, OK? Just say, "I love you" in the car and I'll say it back. Or maybe you can say just, "I love you" when I'm walking away.
(gulp) OK. Wait - so I can say "I love you" when you're outside, just not the other stuff, right?
right
Got it. (sigh)
cool.
They included studies that did not distinguish between planned and unplanned home births. For example, if you had planned a hospital birth, but your labor progressed so quickly that you gave birth before you even made it to the hospital, then you wouldn’t have had a skilled attendant or necessary resources present.
In contrast, a planned home birth means that the woman and her health care provider have determined she is healthy, at low risk for complications, and has the necessary resources in place for a safe birth. By combining the two types of home births, the findings are limited.
Second, a meta-analysis is a way of combining the results of many studies. But in this case, there seems to be no clear reason as to which studies they included versus those they excluded. In fact, they actually did not include the best and by far largest study that's been done—which did not find a higher neonatal mortality rate.
"How will eating chicken fetuses impact my test performance, Mamacita?"
my kid: "Oh yeah - that's my show, son!"
friend: "what is this?"
my kid: "Twelve Angry Men, yo!"
friend: "good stuff, excellent entertainment"
"I'm going to adopt. I can't handle doing that to my body,"
I think I need some of that "kids' clarinet", Mom - I'm really sneezing a lot
...Think about the shape of the uterus. Before labor, the muscle of the uterus is thick evenly around all sides, above, below, behind. As the cervix starts thinning and dilating, all that muscle has to go somewhere – it bunches up at that top. The top of the uterus thickens dramatically the more the cervix opens. During a contraction, at the beginning of labor, check how many fingers you can fit between the fundus (top of your bump) and the bra line – you will be able to fit 5 fingers. As the top of the fundus rises higher during labor, you will fit fewer and fewer fingers. When you can fit 3 fingers, I usually tell mothers they can think about going into hospital as they will find they are around 5cm dilated. At 1 finger, you are fully dilated. (Awesome, huh!)...
...In Tuba City last year, 32 percent of women with prior Caesareans had vaginal births. Its overall Caesarean rate has been low — 13.5 percent, less than half the national rate of 31.8 percent in 2007 (the latest year with figures available). This is despite the fact that more women here have diabetes and high blood pressure, which usually result in higher Caesarean rates...
Dear All: We are holding a tent drive for
our pregnant and birthing Mothers who are
living in rubble and need a dry shelter.
In order to make the ship that is leaving
New Orleans we need these tents shipped to
the to locations below within the next week.
We are looking for tents of all sizes that
are water proof and have a rain shield
protection. In addition, if possible include
a tarp to go with these tents for additional
rain protection. We will shrink wrap and put
these tents on a palate to get to Jacmel
via boat.
Locations to ship tents:
West Coast:Penny Tyrrell
c/o Bumi Sehat Haiti-Tent Drive 93 North Polk
Eugene, OR 97402
East Coast: Andre Gillis
c/o Bumi Sheat Haiti-Tent Drive
417 North Front Street
Philadelphia, PA 19123
Midwest people please mail to the East Coast.
Please share this information with as many
people as you know and provide them the
shipping information.
Thank you for your support. This drive
will continue well beyond the week time
frame so continue to send tents as they
become available.
Thank you, Heather Maurer
Director of LogisticsBumi Sehat Haiti
"HealthConnect One has reserved a block of rooms for overnight stay on Wednesday March 10th at the DoubleTree Washington, 1515 Rhode Island Ave. NW. Please call the hotel directly to make a reservation at 1-800-492-5195. When you call to book your room, please state that you are part of the HealthConnect One Network meeting, in order to take advantage of our $175/night room rate (including breakfast). The deadline for the room block rate is February 15th. You will need to provide a valid credit card number upon booking.
We will begin the Lobby Day activities by attending Senator Richard J. Durbin's constituent coffee on Thursday morning (8:30am-9:30am). We encourage you to schedule visits with your congressional delegation from 10am-noon. HealthConnect One will then host a lunch de-brief session from 1pm-4pm at the DoubleTree Washington following our morning visits on Capitol Hill.
Please let us know by Thursday, February 11, 2010 if you are able to attend!
We can assist you with making appointments with your U.S. Senators' and Representative's offices to request a visit (with your elected official or their health legislative assistant). Further information on Doula Funding talking points will also be provided when you register.
We hope that you will be able to join us for these Lobby Day activities, and that your organization can support your travel expenses. HealthConnect One has a small budget to support travel costs, so if you would like to join us, but your organization is unable to cover travel costs, please contact Mac Grambauer at mac@lmcalpine.com.
For those of you who cannot come with us to Washington, we suggest that you call your elected officials in Washington on March 10 and 11, and ask for their support to continue the funding for community-based doula programs in the FY11 budget.
"Nope - it doesn't work. It's not magic - either it snows or it doesn't."
me: I wish school started two hours late every day
kid: me too. You should talk to B about it.
me: who is "B"
kid: um, our president?!
me: so you guys are on a first letter basis, then?
kid: yup.
LADIES of the UNITED STATES of AMERICA!
WHY WAIT for REFORM THAT MIGHT NOT COME?!
What do you think would happen in every woman in the United States who has any type of maternity coverage called their health care insurer to tell them:
PLEASE CALL YOUR HEALTHCARE INSURER ON FRIDAY, FEBRUARY 5TH. CALL EARLY IN ...THE DAY!
"I WANT SAFE BIRTHING CHOICES FOR HAVING MY BABY OUTSIDE OF HOSPITAL WITH A CERTIFIED PROFESSIONAL MIDWIFE -- AT HOME OR AT A BIRTH CENTER.
WHEN IS YOUR COMPANY GOING TO COVER MY MATERNITY EXPENSES WHERE I WANT TO GIVE BIRTH?"
"I AM PLANNING TO HAVE A BABY NEXT YEAR (OR WHENEVER!) AND I WANT THIS COVERAGE -- SO I'M CALLING YOU & MY EMPLOYER AND MY STATE INSURANCE COMMISSIONER THIS WEEK TO ASK THIS SAME QUESTION & I NEED AN ANSWER BY [ DATE ].
"
What if these insurers were SIMPLY BLASTED with phone calls, faxes, emails, and other contacts? What do you think their response would be?
I don't know -- if we kept it up for about 1 week -- we might actually demonstrate to these huge companies that what women need is important and they need to listen to us! AND it might make Congress sit up & take notice.
And it wouldn't hurt to call your employer's HR department -- remember THEY are the purchasers of these policies -- and be sure that Licensed Midwives, Certified Professional Midwives, and birth outside hospital is covered in ALL STATES.
Don't wait for Congress to MAYBE do this -- DO IT NOW!
"Who ya gonna call?!" -- Always ask for a Case Manager over OB services! NEVER speak to the first person who answer the phone! They are trained to say, "No, that's not covered," or "I don't know."
THEN get the name & direct phone number of the person with whom you spoke.
Let's get it together Ladies -- and DEMONSTRATE OUR BUYING POWER!
"Comparison Shopping has never been more important!'
Joyce Moxley Thomas, MHA, CPM/LM, HCHICertified Professional Midwife/LM239Certified Hypnobabies InstructorCertified Perinatal Massage Therapist
Executive DirectorAmazing Babies Midwifery Education13768 Roswell Ave. #209Chino, CA 91710909-591-2924www.Amazing-Babies.com
AquaNatal Birth Center13768 Roswell Ave. #209Chino, CA 91710909-591-2924www.AquaNatalBirthCenter.com
Many hospitals have been advising all laboring women to not eat or drink during labor in case they need emergency surgery with general anesthesia. But isn't that kind of like advising everyone to skip breakfast in case they get hit by a bus?
Are the chances of having an emergency C-section really comparable to getting hit by a bus? I've definitely heard of more C-sections than I have bus accidents in the past...My reply:
Sure, Molly - the chances of having a labor culminate in a cesarean are, possibly, higher than having a random accident (edited to add: I'm guessing here - a less lazy/busy person might add some statistics - chime in if ya got 'em!). However, I think it's VERY important to differentiate between unplanned cesareans and true emergency cesareans. Many woman will call their unplanned cesareans "emergency" when in fact they were actually unplanned and while there was perhaps not an easy-breezy pace, there was likely time for regional anesthesia. I have, luckily, been a part of only one true emergency cesarean in about 400 births.
As I said, the chances of needing energy for labor is 100%...and not having sufficient energy can actually lead to unnecessary cesareans if the laboring woman is unable to carry on or her labor stalls and augmentation of that labor leads to fetal distress. Avoidable cesareans (major abdominal surgeries) pose risks to moms and babies. So the extremely small risk posed by eating in labor is, in my opinion, worth it.
Coincidentally, an OB from a respected hospital in Boston recently quoted in the NY Times used a very similar example and line of reasoning to my bus idea, so I'm comfortable with my statement. I'll post this in a blog entry & try to find the NY Times article too. Thanks for your important question.
best,
Kim
“My own view of this has always been that you could say one shouldn’t eat or drink anything before getting into a car on the same basis, because you could be in an automobile accident and you might require general anesthesia,” said Dr. Marcie Richardson, an obstetrician and gynecologist at Harvard Vanguard Medical Associates in Boston, who was not connected to the new study.
Jan-25-2010
Urgent Call for Human Milk Donations for Haiti Infants
Salem-News.com
Donor milk provides unique protection for fragile preterm infants, mothers who are willing to donate human milk should contact their regional Mothers’ Milk Bank.
(PORTLAND, Ore.) - The Human Milk Banking Association of North America (HMBANA), United States Breastfeeding Committee (USBC), International Lactation Consultant Association/United States Lactation Consultant Association (ILCA/USLCA), and La Leche League International (LLLI) are jointly issuing an urgent call for human milk donations for premature infants in Haiti, as well as sick and premature infants in the United States.
This week the first shipment of human milk from mothers in the United States will be shipped to the U.S. Navy Ship “Comfort” stationed outside Haiti. “Comfort” is currently set up with a neonatal intensive care unit and medical personnel to provide urgent care to victims of the earthquake.
An International Board Certified Lactation Consultant stationed at the U.S. Navy base in Bethesda, MD is assisting with providing breast pump equipment and supplies to the “Comfort.” Dr. Erika Beard-Irvine, pediatric neonatologist, is on board the “Comfort” to coordinate distribution of the milk to infants in need. HMBANA, USBC, ILCA/USLCA, and LLL are responding to requests to provide milk for both premature infants and at-risk mothers who have recently delivered babies on board the U.S.N.S. Comfort, but an urgent need exists for additional donations.
At the current time, the infrastructure to deliver human milk on land to Haiti infants has not yet been established. As soon as that infrastructure is in place, additional donations will be provided to older infants.
Mothers who are willing to donate human milk should contact their regional Mothers’ Milk Bank of HMBANA. A list of regional milk banks is available at the HMBANA website at www.hmbana.org.
Currently milk banks are already low on donor milk. New milk donations will be used for both Haiti victims as well as to replenish donor supplies to continue to serve sick and premature infants in the U.S. Donor milk provides unique protection for fragile preterm infants.
Financial donations are also strongly encouraged to allow HMBANA, a nonprofit organization, to continue serving infants in need.
UNICEF, the World Health Organization, the Emergency Nutrition Network, and medical professionals all recommend that breastfeeding and human milk be used for infants in disasters or emergencies. Human milk is life-saving due to its disease prevention properties. It is safe, clean, and does not depend on water which is often unavailable or contaminated in an emergency.
Relief workers, health care providers, and other volunteers are urged to provide support for breastfeeding mothers to enable them to continue breastfeeding, and to assist pregnant and postpartum women in initiating and sustaining breastfeeding.
For more information, contact HMBANA at 408-998-4550 or hmbana.org. Additional information can be provided from the United States Breastfeeding Committee at 202-367-1132 (usbreastfeeding.org), ILCA/USLCA at 1-800-452-2478 (www.ilca.org or www.uslca.org), or La Leche League at 847-519-7730 (llli.org).
NEW YORK (Reuters Health) - There is no reason why pregnant women at low risk for complications during delivery should be denied fluids and food during labor, a new Cochrane research review concludes.
..."Women should be free to eat and drink in labor, or not, as they wish," the authors of the review wrote in the Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research....
...Standard hospital policy for many decades has been to allow only tiny sips of water or ice chips for pregnant women in labor if they were thirsty. Why? It was feared, and some studies in the 1940s showed, that if a woman needed to undergo general anesthesia for a cesarean delivery, she might inhale regurgitated liquids or food particles that could lead to pneumonia and other lung damage.But anesthesia practices have changed and improved since the 1940s, with more use of regional anesthesia and safer general anesthesia...
...And recently, attitudes on food and drink during labor have begun to relax. Last September, the American College of Obstetricians and Gynecologists (ACOG) released a "Committee Opinion" advising doctors that women with a normal, uncomplicated labor may drink modest amounts of clear liquids such as water, fruit juice without pulp, carbonated beverages, clear tea, black coffee, and sports drinks. They fell short of saying food was okay, however, advising that women should avoid fluids with solid particles, such as soup...
...Singata and colleagues systematically reviewed five studies involving more than 3100 pregnant that looked at the evidence for restricting food and drink in women who were considered unlikely to need anesthesia. One study looked at complete restriction versus giving women the freedom to eat and drink at will; two studies looked at water only versus giving women specific fluids and foods and two studies looked at water only versus giving women carbohydrate drinks.
The evidence showed no benefits or harms of restricting foods and fluids during labor in women at low risk of needing anesthesia.
...Singata and colleagues acknowledge that many women may not feel like eating or drinking during labor. However, research has shown that some women find the food and drink restriction unpleasant. Poor nutritional balance may be also associated with longer and more painful labors. Drinking clear liquids in limited quantities has been found to bring comfort to women in labor and does not increase labor complications.
"My birthday is Martin Luther King Jr's birthday and so I think I should celebrate his birthday, and mine, on the actual day"
December 30, 2009 Joanna Blum and Ashley Hutcheson talk about their extraordinary meeting to record the life and passing of Baruch Levi Blum. On Dec. 1, Blum gave birth to Baruch Levi. He weighed 2 pounds, 11 ounces. He lived about 10 minutes. Hutcheson, a photographer, was there to document his birth.
In a Nielsen survey, it was pointed out that 70% of people surveyed believed opinions they read about something online. It was the second highest level of trust people gave (trusting their known friends came first). So, just by writing something down online, 3/4 of the population will believe what is written. If you’re evil, this is awesome. If you’re a good person, this requires a little bit of thought.
The Food and Drug Administration is reviewing BPA, and they will release their recommendations next week. The more of us working together right now to finally rid food containers of toxic BPA, the better.
That's why we're partnering with CREDO Action on this last-minute push to keep our food safe. There's nothing quite as good as doubling down to increase the odds of getting toxics out of our food containers.
It's time for action. Join us in signing CREDO Action's petition to FDA Commissioner Margaret Hamburg urging a ban of BPA in all food packaging!
http://act.credoaction.com/campaign/fda_no_bpa/
Did you know that Bisphenol-A (BPA) has been implicated in everything from miscarriages to cancer to sexual dysfunction? And it can be found in your food containers! BPA is in a broad range of food packaging including baby bottles, water bottles, almost all soda can liners and many other types of packaging.
Make no mistake, BPA gets into our food: Consumer Reports and the Environmental Working Group have both studied the issue and found BPA in many of the canned products they tested, including infant formula, vegetables, soda and soup. And we are what we eat. BPA is present in detectable levels in over 90% of Americans' bodies.
Hundreds of studies have confirmed the dangers of even low-level doses of BPA. The risks are severe enough that the prestigious Endocrine Society released a special statement last summer explicitly warning that low-level exposure to BPA can adversely affect female and male reproduction, thyroid function, and metabolism, and could even increase obesity. 1
There is already overwhelming evidence that BPA is dangerous to our health. It has no place in our food, or our children's food, even at the lowest levels. It's time for the FDA to put people's safety above corporate profits. When the FDA releases its BPA review on November 30, the agency should call for an immediate ban on the use of BPA in any and all food packaging, including baby bottles and can linings, and should further require companies to fully test and disclose the nature of all chemical ingredients used in food packaging and linings.
Let the FDA know it's not OK for bottles or food packaging to contain dangerous chemicals. Tell FDA Commissioner Margaret Hamburg that enough is enough, join us in signing CREDO Action's petition, which they'll deliver to the FDA.
Physicians should no longer automatically opt to perform a cesarean section in the case of a breech birth, according to new guidelines by the Society of Obstetricians and Gynecologists of Canada.
Released yesterday, the guidelines are a response to new evidence that shows many women are safely able to vaginally deliver babies who enter the birth canal with the buttocks or feet first.
read entire story here
from BBC news:
click here to see a video interview - one story of loss, right here in NJ
Maternal mortality across the worldThe US spends more money on mothers' health than any other nation in the world, yet women in America are more likely to die during childbirth than they are in most other developed countries, according to the OECD and WHO. The BBC's Laura Trevelyan has been trying to find out why.
Four million American women give birth every year, and about 500 die during childbirth or from pregnancy-related complications.
In the richest nation in the world, giving birth is more risky than you would think.
"No American woman should die from childbirth in 2009, we can definitely do a lot better," says Dr Michael Lu, Associate Professor of Obstetrics at the University of California, Los Angeles (UCLA).
In New Jersey, Jim Scythes is bringing up his two-year-old daughter Isabella on his own.
His wife, Valerie, died from blood clots shortly after giving birth to Isabella by Caesarean section.
Jim still cannot believe that Valerie died after giving birth, here in America.
"When Isabella walked for the first time, I sat on the floor and cried, because Valerie should have been there. I believe this could have been prevented and now my daughter will never know her mother."
In 2001, the UN set itself the goal of slashing maternal mortality by 75% by 2015, but it is nowhere near meeting that target.
Health ministers from around the world are meeting in Ethiopia to work out how to make up for lost ground.
The BBC is publishing a series of reports to mark the occasion.
So why are women in America more likely to die during childbirth than they are in most other developed nations?
The answers are complex. A healthcare system which leaves what Dr Lu estimates are 17 million women of child-bearing age without health insurance could be one factor.
Obesity, poverty and the high rate of C-sections in America all play a part.
Dr Lu says about half of American women are entering pregnancy overweight. "Obesity is a major risk factor for pregnancy-related complications.
"First we need to improve the health of women before they get pregnant, and second we need to improve the quality of maternal care in America."
Shocking story
The Centres for Disease Control (CDC) in Atlanta is the US government agency that collects national statistics on the numbers of women dying during childbirth.
Dr Bill Callaghan of the CDC says the latest maternal mortality data suggests one in four to one in five women who die have heart disease, or diseased blood vessels.
To the extent that we don't explain racial disparity in pregnancy-related mortality, we're going to have difficulty making headway into it
Dr Bill Callaghan
Centers for Disease ControlCould that be due to women being overweight? I asked. "It could be," replies Dr Callaghan, "the obesity epidemic has not spared women of reproductive age."
Dr Bill McCool, at the University of Pennsylvania's School of Nursing, points out that America is far above the World Health Organization's goal of a 15% C-section rate.
"Surgery of any kind has risk," he says, and a C-section is, "still the riskiest way to have a baby.
"In the US, almost one third of women have that procedure for delivery of their baby."
The statistics on maternal mortality in America tell a shocking story when it comes to African-American women.
They are three to four times more likely to die during childbirth than white American women.
Dr Bill McCool says that even wealthy black American women have a higher rate of mortality during childbirth than wealthy white women.
"People have looked at this from different angles.
"We know that African-American women tend to have higher blood pressure than the rest of the population, so is there a link there?"
JoAnne Fischer, Executive Director of the Maternity Care Coalition, which works with low income women to help them stay healthy during their pregnancies, says: "We do know that there is extraordinary stress involved in racism and in being poor. "
"And we know that sometimes this creates hypertension.
"Hypertension, obesity and diabetes are all linked, so we have to make sure women start their pregnancies healthy."
Dr Bill Callaghan, of the CDC, finds that not knowing why African-American women are at greater risk when giving birth has given him and his colleagues' sleepless nights.
"We can say that some of this may be due to socio-economic disparities.
"But it does not explain all of it.
"And to the extent that we don't explain racial disparity in pregnancy-related mortality, we're going to have difficulty making headway into it."
As doctors and US officials try to work out why American women are dying in childbirth, and what can be done to prevent it, Jim Scythes is still mourning his wife Valerie, who was all too briefly a mother.
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