Natural Family News

Indiana is one of nine states that requires midwives to be licensed to attend homebirths, but then provides no way for them to do so. The state does not recognize Certified Professional Midwives (CPMs), a title awared by the North American Registry of midwives. Every year since 1993, legislation has been introduced into the Indiana senate to try to legalize CPMs, and every year it has been blocked by one senator who doesn’t want to see it happen. Senator Pat Miller (R) has been using her power as chair of the Senate Public Health Committee to kill the legislation in committee before it ever has a chance to go to the floor for a vote. Meanwhile, somwhere in the neighborhood of 50 CPMs continue to practice in Indiana, risking prosectution for practicing medicine without a license.

Perineal massage in the last four to five weeks before childbirth resulted in a 15% reduction in episiotomies, according to a new study. An additional benefit was less perineal pain after birth. Perhaps now that it’s made it into some medical studies, doctors will begin recommending what midwives have recommended all along.

A San Antonio hospital has added postpartum massage to the list of services offered to their new moms. I was supposed to have a massage therapist at my last birth, which was a homebirth, but that didn’t work out. But I think I might try harder next time to make it work, or to at least plan for a postpartum massage. It sounds great, and it’s nice to hear that hospitals are doing something other than dispensing pills to help with postpartum discomfort.

An article out of Australia says that waterbirth there is on the rise, with one hospital citing a 38% waterbirth rate. I think it’s fabulous that more women are being informed about the benefits of laboring and/or birthing in the water. Most moms who have done so say they’d never go back to birthing “on land”. But even though several hospitals there have waterbirth facilities, the Australian Medical Association won’t support waterbirth, claiming it is too risky. It’s a shame that medical organizations seem to be so quick to accept research that support the use of more interventions, but dismiss research in support of more natural birth methods. You can read the article here.

I had to make a trip to one of the baby superstores to buy a shower gift, and while standing in line a book caught my eye. The title was “Enjoy Your Labor: A New Approach to Pain Relief for Childbirth.” The subtitle said “the only book that takes the fear, mystery, and guilt out of epidurals and spinals.” I was so taken aback that I decided I had to look the book up when I got home. The author, who is (not surprisingly) an anesthesologist, advocates for the use of epidurals early on, “before the severe pain of labor starts.” So, basically, you should get one before you even know if you’re going to need one. Now, while I’m not thrilled with the subject matter of the book at all, I am particularly offended by the idea that you have to have an epidural to enjoy your labor. I suppose it could be a matter of what he means by enjoy; to me sitting around disconnected from what is going on inside my body, watching television and chatting with others would not constitute enjoying labor. On the other hand, even though some of my labors have been quite difficult, I would still say that I have enjoyed the birth process. You can read more about the book here.

Richmond, Virginia is hosting an arts festival centered on childbirth. The festival, “Defining Moments: An Exploration of Birth through the Arts,” will include dance performances, film screenings, panel discussions, workshops and art exhibits.

One of the central parts of the festival will be the performance of a play by Karen Brody entitled Birth. Brody wrote the play after becoming convinced women give up a lot of power when making decisions about childbirth. The play focuses on the birth experiences of seven educated, middle-class women.

Gweneth Paltrow, who has been sort of a boon for natural birth and breastfeeding, is planning a waterbirth for her second child who is due in May. Apparently she had considered waterbirth the first time around, but didn’t feel confident enough to try it at the time. She has a birth tub at both her home in London and in New York, so she should be well prepared! You can read about it here.

A new study from UT Southwestern shows that someone standing in your face counting to ten and screaming “push” is not really beneficial after all. No, really? What a surprise. The study found that directed pushing did not significantly shorten the pushing stage, and may lead to issues with incontinence later in life. You can read more here.

A recent study in the American Journal of Epidemiology showed that exposure to trihalomethanes, a chemical used to disinfect drinking water, during the second trimester of pregnancy may be associated with low birth weight. The risk seems to be highest for minority women, who had a 60% increase in risk of low birth weight when exposed to high levels of trihalomethanes; for Caucasians the increased risk was 37%. You can read the journal abstract here.

ACOG NEWS RELEASE

For Release: November 30, 2005
Contact: ACOG Office of Communications
(202) 484-3321
communications@acog.org

Vaginal Birth Not Associated With Incontinence Later in Life

Washington, DC — Contrary to the belief held by some, vaginal birth does not
appear to be associated with incontinence later in life, a new study has found.
The study, published in the December issue of Obstetrics & Gynecology,
found that incontinence was more strongly related with family history.

An estimated 30-50% of adult women suffer from urinary incontinence, and
vaginal delivery is often considered to be the major risk factor for stress
urinary incontinence. While 62% of urogynecologists previously surveyed
would support performing elective cesarean deliveries to prevent
incontinence in the long term, the benefit of this practice has not been proven.
Risk factors for incontinence include body mass index, hypertension, and
integrity of the pelvic floor, all of which tend to run in families.

Researchers from the University of Rochester Medical Center in New York
studied 143 pairs of biological sisters. All of the women were at least 45 years
old and postmenopausal. All but two pairs of sisters were Caucasian.
However, one sister of each pair was nulliparous (no deliveries) and one was
parous (at least one vaginal delivery). The women answered questionnaires
and underwent clinical testing to measure incontinence.

The researchers found that the rate of incontinence was 47.6% for nulliparous
women and 49.7% for parous women, a statistically insignificant difference.
They did discover, however, that 63% of the pairs shared continence status
(i.e. either both were continent or both were incontinent). The researchers say
that their findings run contrary to the conventional wisdom that nulliparity
protects against incontinence and are similar to findings from their earlier
study of nuns who had never given birth and yet still had high rates of
postmenopausal incontinence.

While further research is needed to determine if there is a genetic component
to incontinence, the researchers say that this study indicates that family
history is more strongly associated with incontinence than a history of vaginal
delivery.

Contact: Gunhilde M. Buchsbaum, MD, University of Rochester Medical
Center, Rochester, NY, at gunhilde_buchsbaum@urmc.rochester.edu.

# # #

The CDC has released some preliminary data on infant and maternal health from last year, and while I’m saddened to see the numbers, I can’t say I’m surprised. The c-section rate was at an all time high of 29.1%, and VBACs decreased to 9.2%. What is even more telling, though, is that despite all our technological advances and interventions, we’re not getting better results. Preterm births were also at an all time high, and low birth weight is an increasing problem. You can read the whole report from the CDC here.

I’m surprised that I haven’t seen more of an uproar about ER’s treatment of extended breastfeeding. Last week, they had an episode where a mother came to ask for a place to nurse her child. They pointed her to a private location, at which point her child (who was about 6) came up to tug on her arm and say “Come on, Mom. Let’s go! I’m starving!” Then all the nurses and doctors snickered and exchanged looks. As if that’s how extended nursing goes…

Then ER ran an episode with a breech birth. OF COURSE the baby ended up brain damaged after getting stuck in the birth canal. The weird thing was the ob doc was not totally opposed to the mother trying to give birth vaginally, but the ER doc was just absolutely insistent that she ought to have a c-section. When he tried to coerce her into a c-section one of the nurses started giving her all the risks, and she changed her mind. There as a brief discussion about “informed consent” between the doctor and the nurse.

In other media news, there is a new show called “Close to Home” on CBS, I think. It was very positive in the breastfeeding realm. The mother, who is a lawyer, even got them to bring in a mini fridge to her office after she put her pumped breastmilk in the common refrigerator, and the boss almost drank it. I was a little irked at how much stress they put on the idea that a 3 month old should be sleeping through the night but, all in all, it was favorable towards nursing.