I just find this sad. Birth is hard work, sure – but our bodies were designed to do it. It’s hard to believe that most of these women truly understand the risks they are taking by choosing this route.
You can read about it here
A newly published study found that children born via c-section were twice as likely to be allergic to or intolerant of cow’s milk than their vaginally born counterparts. This is thought to be related to the lack of colonization by normal maternal flora that occurs during vaginal birth. A short discussion of the article is here
Add another fad to the growing list for expectant parents: do-it-yourself Doppler. While devices for listening to your baby’s heartbeat in the womb have been on the market for a while, up to this point they have been glorified stethoscopes. Now parents can rent (or buy) their own Doppler device, similar to the ones used by most doctors, and use them at home. Most medical professionals believe that ultrasound technology is safe, but the subject is somewhat controversial. Listening with a Doppler device exposes the growing baby to quite a bit of ultrasound, and it is not known what the effect of long-term exposure really is. You can read more here
This article does a decent job of addressing the problems facing women who want to avoid having a c-section, whether they are being denied a VBAC, or are told their baby is too large, etc. I would question some of their statistics – I think first time moms probably have unnecessary c-sections way more than 11% of the time, for example – but I’m glad the subject is getting so much press lately. You can read the article here
Despite repeated scientific studies that have demonstrated the worthlessness of routine episiotomy, it’s still alive and well. A new study out of Canada shows that in some parts of the world 9 out of 10 first time mothers are given an episotomy. The good news: in some other countries the rates are much lower; Sweden has an episiotomy rate of under 10 percent.
Read a summary here
The VBAC war continues to rage, and large numbers of women continue to be victims of it. It is becoming increasingly difficult for woman to have a VBAC at a hospital, even if she is an excellent candidate for one. It’s no secret what is driving the VBAC ban – litigation. It’s not about VBAC being an unsafe choice medically, it’s about VBAC being a risky choice for doctors legally. One chief of obstetrics is quoted in the article as saying that the risk of uterine rupture may seem quite low, but that “it’s damn high if you’re the one” (that it happens to). Yes, that’s true. But the same could be said for a repeat c-section. The risk of death from anesthesia, hemorrhage, emergency hysterectomy, etc. is quite low, but if you’re the one it happens to it’s “damn high.” The reasonable thing to do is to compare relative risk, and the fact is that the risk of dying from anesthesia from a c-section is higher than the risk of dying from a uterine rupture.
You can read the article here
It seems that mothers with dental cavities may have children at increased risk for developing cavities if those children are born by c-section. Apparently, this is due to decreased exposure to bacteria in the mother’s body. In a vaginal delivery, there is more opportunity for exposure to the mother’s flora. Read more.
July 27, 2005
LEAWOOD, Kan. – Updating its 1995 policy, the American Academy of Family Physicians today released an updated clinical practice guideline on trial of labor after cesarean (TOLAC). Key updates to the guideline include recommendations that prostaglandins should not be used for cervical ripening or induction and that TOLAC should not be restricted only to facilities with available surgical teams present throughout labor. The guideline does state, however, that a management plan should be in place for each woman undergoing TOLAC in case of uterine rupture or other potential emergencies requiring rapid cesarean section.
The objective of the guideline is to provide an evidence-based clinical practice guideline for pregnant women and their families, maternity care professionals, facilities and policy-makers. The updated guideline is published as a supplement to the online version of the July/August issue of Annals of Family Medicine.
With births by cesarean accounting for approximately 28 percent of all births, the AAFP’s TOLAC guideline offers pregnant women giving birth in facilities that follow the guideline, especially those in rural areas, the option of attempting vaginal birth without mandating the presence of a surgical team. Often, women in rural areas are not given the option of TOLAC because of previous assumptions that a surgical team must be present for these women to attempt to deliver vaginally. The guideline states that TOLAC should not be restricted only to facilities with available surgical teams present throughout labor since there are no studies that show these additional resources result in improved outcomes. This recommendation differs from that of the American College of Obstetricians and Gynecologists (ACOG) in that the ACOG guideline states patients attempting vaginal birth after cesarean (VBAC) should have “physicians immediately available to provide emergency care.”
“The AAFP’s TOLAC guideline reflects family medicine’s patient-centered approach to care, while continuing the AAFP’s dedication to promoting evidence-based medical practices,” said Dr. Mary Frank, AAFP President. “This will better inform the discussion a pregnant woman has with her family physician.”
To develop the updated guideline, the AAFP’s Commission on Clinical Policies and Research convened a panel of family physicians with particular expertise in this area of maternity care to review the available evidence on TOLAC using the Agency for Healthcare Research and Quality “Evidence Report on Vaginal Birth After Cesarean (VBAC).” The panel also conducted a systematic review of articles published since the evidence report was released.
American Academy of Family Physicians: Founded in 1947, the American Academy of Family Physicians represents more than 94,000 physicians and medical students nationwide. It is the only medical specialty society devoted solely to primary care. Please visit www.aafp.org for more information about AAFP.
Editor’s Note: A complete copy of the guideline “Trial of Labor After Cesarean (TOLAC), Formerly Trial of Labor Versus Elective Repeat Cesarean Section for the Woman With a Previous Cesarean Section” can be accessed at http://www.aafp.org/tolac.xml
A newly published study found that women who had undergone a cesarean section were less likely to get pregnant again. However, it didn’t examine whether this had anything to do with infertility or if it was the result of a lack of desire to have another child. It could be that if a woman had a hard recovery from the c-section she might be reluctant to put herself in the position of possibly going through that again, or that women who are not planning to have any more children may be more willing to agree to a c-section. Regardless, it’s an interesting read.
You can see the article here
For those of you who read a lot of birth things, this article may contain some really familiar phrases, but, like the author of the story, I had to ask “what monkey?” I thought this was a great article about the homebirth process. It contained statistics and reasons for homebirthing, but mostly it was just a father’s journey through the process of pregnancy that ends in homebirth. Read it. You’ll be glad you did.
Moms: Do you really need that C-section or epidural? Registered nurse and midwife Breck Hawk, author of “Hey! Who’s Having This Baby Anyway?” reveals why these procedures are often unnecessarily prescribed during labor and shares how you can avoid them.
San Diego, CA (PRWEB) July 25, 2005 — Studies show birth is most common Monday through Friday, 9 a.m. to 5 p.m. Is this just coincidence or is it a contrived effort by providers to control personal schedules?
Pregnant women are encouraged to welcome the chance to have their baby on a scheduled date for the convenience of their provider. But often they’re not told the risks and side effects involved. They don’t realize that some interventions – such as pain medications, epidurals, C-sections, or birthing the baby with forceps or vacuum extraction – may not only be unnecessary, but also dangerous.
“Moms-to-be may blindly trust providers, thinking everything suggested is good – but this isn’t always true,” says registered nurse and midwife Breck Hawk, author of “Hey! Who’s Having This Baby Anyway?” (Metropolis Ink, $19.95, www.HeyAnyway.com). “Unless it’s anatomically necessary, women deserve and need to be told they probably birth babies vaginally and naturally.”
Hawk has over 27 years experience as a midwife, doula, prenatal instructor, and registered nurse specializing in maternity and neonatal intensive care. She has helped hundreds of women give birth. Here she reveals how to avoid common interventions and have a successful birth.
*Hire a doula or professional labor support person.
*Exercise during pregnancy. This strengthens muscles and prepares your body for the long stress of labor.
*Consider a birth center or having a homebirth with a midwife.
*Attend childbirth classes that teach non-pharmacological methods of pain relief such as yoga, HypnoBirthing, Lamaze, and others.
*In the hospital, ask to be assigned to the nurse who is the strongest supporter of natural childbirth.
*Before taking pain medication, ask for a vaginal exam. See how far your cervical dilation has progressed. You may be further along than you thought and decide to forego the medication.
No matter what’s on your provider’s personal agenda, remember it’s your body and your baby and it’s your right to have the last word regarding your baby’s birth!
How birth-savvy are you? Take the 12 Question Quiz for Moms-to-Be or purchase your copy of “Hey! Who’s Having This Baby Anyway?” at www.HeyAnyway.com.
Dr. Colleen Murphy, an OB-Gyn in Anchorage, has had her license to practice pulled because Alaska Regional Hospital is concerned about her actions in ten different cases over an 18 month period. They claim that she is endangering patient lives by not managing labors appropriately. She claims that she is being singled out because she is a natural birth advocate, with a c-section rate of under 8%.