Home Birth and Midwifery in the News...

There have been several articles in the news lately regarding Birth, Midwives, and Out of Hospital Birth, specifically Home Births.

http://abcnews.go.com/Health/Wellness/cdc-home-births-rise-us/story?id=9998349

http://www.theunnecesarean.com/blog/2010/5/17/alabama-cesarean-rates-by-hospital-2008.html

http://www.theunnecesarean.com/blog/2010/9/13/read-the-subtext-acogs-position-on-home-birth.html

http://articles.mercola.com/sites/articles/archive/2010/09/28/home-birth-is-safer-than-hospital-birth.aspx?aid=CD945

http://www.facebook.com/l.php?u=http%3A%2F%2Fireport.cnn.com%2Fdocs%2FDOC-478927&h=40f62

http://www.medicalnewstoday.com/articles/202532.php

http://www.seattlemidwifery.org/news.html

This year the CDC released a report on births, and they have seen that Homebirths are on the rise.
http://www.cdc.gov/nchs/data/nvsr/nvsr58/nvsr58_11.pdf
http://dl.dropbox.com/u/2847775/Staying%20home%20to%20give%20birth%20JMWH.jpd.pdf
http://www.usatoday.com/news/health/2010-03-04-homebirth04_ST_N.htm
http://www.washingtonmidwives.org/assets/big-push-nvsr-release.pdf
http://www.npr.org/blogs/health/2010/03/home_births_rise.html
"The number of Alabama families giving birth
out of hospital without regulated maternity care providers is
increasing faster than the national average." In AL the rise was 18% compared to 3-5% nationally.

http://www.thedailybeast.com/blogs-and-stories/2010-10-02/home-births-under-fire-amid-outcry-over-wax-paper/
Jennifer Block wrote an article about a study (a very poorly done study), that said HB is 3 times deadlier than hospital birth... This is part of what she had in her article...
*The medical community calls home births unsafe, but recent large studies comparing home to hospital show why women with uncomplicated pregnancies would choose the former: They are much more likely to avoid the complications of surgery or tearing, they are more likely to breastfeed, and they are happier.

...Meanwhile, rival journal The Lancet took the study at face value, publishing an editorial under the headline “Home Birth—Proceed with Caution,” with a stern warning: “Women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk.”

“That was really offensive,” said Marjorie Greenfield, M.D., a professor of OB/GYN at Case Western Reserve who submitted a letter to The Lancet along with several other physicians. “But you know, I can understand, because there’s such a deep, deep belief that it is unsafe to have a baby at home. I used to believe that! But when you look at the good studies of home birth, there’s no difference in baby outcomes, and probably improved outcomes for mothers.” Still, she added, “most people I work with think it’s self-indulgent and risky.”

Last week here in Alabama we had families from all over the state gather in 7 cities and we Walked for Midwives, in an effort to help bring awareness to the issue, and to garner support. The Alabama Birth Coalition is trying to help get legislation passed to allow and License Certified Professional Midwives.
Here in our fair city... we caused a stir!
http://www.facebook.com/l.php?u=http%3A%2F%2Fblog.al.com%2Fbreaking%2F2010%2F09%2Fmidwife_advocates_march_throug.html&h=65d6b

In response to this -
The President of the Alabama Chapter of the American Academy of Pediatrics wrote an article
http://www.facebook.com/l.php?u=http%3A%2F%2Fblog.al.com%2Fpress-register-commentary%2F2010%2F10%2Fyour_word_lay_midwifery_an_unn.html&h=65d6b

This was then written in response to the article:
*The president of the Alabama Chapter of the American Academy of Pediatrics displayed his woeful ignorance of birth, midwifery and the current proposed legislation to provide Alabama women with birth options.
I urge people to learn the facts and then educate him on the topic. http://www.facebook.com/l.php?u=http%3A%2F%2Fwww.frazzalicious.com%2F&h=65d6b
This is the official response from the Alabama Birth Coalition to the specific article written by Dr James C. Wiley.
http://blog.al.com/press-register-commentary/2010/10/your_word_a_wonderful_option.html
They make sure to explain that ABC is not trying to get licensure for untrained 'lay' midwives, but are seeking recognition and licensure for Highly Trained and skilled Certified Professional Midwives.

Things have certainly been heating up... Now if we can just get the law passed here in Alabama, so many mom's would be so happy, and planning for their births would be so much nicer as well!

Induction Increases the Risk of C-Section and C-Section increases Newborn Infection

Induction Increases the Risk of C-Section and C-Section increases Newborn Infection
Posted by Nicole D. over at Wonderfully Made Bellies and Babies
http://wonderfullymadebelliesandbabies.blogspot.com/

Labor Induction and the Risk of a Cesarean Delivery Among Nulliparous Women at Term, a recent study published with the American College of Obstetrics & Gynecology (July 2010 - Volume 116 - Issue 1 - pp 35-42) gave the following conclusion:

Labor induction is significantly associated with a cesarean delivery among nulliparous women at term for those with and without medical or obstetric complications. Reducing the use of elective labor induction may lead to decreased rates of cesarean delivery for a population.
This makes for even more worrisome fodder, as the study also includes this information:

Labor induction was used in 43.6% of cases, 39.9% of which were elective.
Inductions for 43.6% of cases?! How many inductions are too many?? And, based on the information given just previously, how many of those resulted in maternal or newborn risk?

Another study printed with the National Academy of Sciences researched what microbiota habitat a newborn at birth... depending on their mode of birth. The small study found that:

those born vaginally tended to get colonized by bacteria such as Lactobacillus from the mother's vaginal canal. C-section babies, however, got more Staphylococcus, a type of microbe usually found on the skin and one that sometimes causes nasty infections. - "Babies' First Germs Depend On Type Of Birth", Chao Deng, NPR

So, in conclusion, to lower cesarean rates and increased risk of newborn strep infections, we should stop inducing for mundane reasons. To lower strep infections, lower the risk for newborn death, respiratory distress, incidences of autism and other SENs, and modestly lowered IQ scores, we need to stop inducing so much.

This is only the tip of the iceberg, people. Oh, the tangled web we weave.

Fantstic post Nicole D.
I love how you put the two new studies together to make them make even more sense! If only people would listen... Wendy - Mother, Doula, Childbirth Educator, Student Midwife, concerned citizen...

An Excellent Video discussing Cord Clamping

“Another thing very injurious to the child, is the tying and cutting of the navel string too soon; which should always be left till the child has not only repeatedly breathed but till all pulsation in the cord ceases. As otherwise the child is much weaker than it ought to be, a portion of the blood being left in the placenta, which ought to have been in the child.”
Erasmus Darwin, Zoonomia, 1801

http://www.youtube.com/watch?v=uQqLnwGv0w0

Info on research about delayed cord clamping to let the baby get the full blood volume intended.

*A thought I have had about cord blood banking.
I think it is a good idea, especially if you already have a family history of certain disease and illness. However, I personally believe that God had/s a design, and if the baby was supposed to be cut off from that blood volume, (up to a cup?) and oxygen it provides for those first few minutes after birth, then the cord would automatically cut free on it's own, and the cord would not continue to pulse and give aditional blood through the placenta to the baby at birth... Wendy Robertson *

The baby is still receiving oxygented blood through the placenta while the cord is still pulsing right after birth. If we leave this alone, the baby doesn't have the NEED to imediately take a breath. When the cord is imediately cut, in modern medical practice, the baby frequently requires additional oxygen as that natural source of oxygenated blood has litterally been cut off, too soon.

The umbilical cord if left alone ceases to pulse with the blood from the placenta. It will physiologically clamp itself off, by filling with Wharton's Jelly. Soon after the placenta will naturally release, and be delivered. What an incredible design God has in place to ensure the survival of the newly born infant.

http://www.cordclamp.com/

Dr. Stuart J. Fischbein's letter in response to ACOG and their HB Ban

http://birthactioncoalition.com/letter/stuart-j-fischbeins-letter-acog-with-responses


Fri, 06/27/2008 - 07:03 — admin
From: Stuart J. Fischbein, MD FACOG
To: Douglas H. Kirkpatrick, MD, President, American College of Obstetricians and Gynecologists
Date sent: Monday, June 23, 2008
Douglas H. Kirkpatrick, MDThe American College of Obstetricians and GynecologistsPO Box 96920Washington, DC 20090-2188Dear Sir:I am a practicing OB/GYN in southern California and Fellow of ACOG and recently was informed by midwife colleagues of your recommendation and encouragement for the AMA to lobby Congress for a law banning out of hospital birth. It is disturbing to me that I had to hear of this decision from outside sources and was never approached by my college to see how I or my local colleagues felt about it. I have grave concerns regarding my organization taking such a stand. I think we are all agreed that ACOG has a statement regarding patients’ rights to informed consent and informed refusal. Yet, it seems with every decision our organization moves further away from that basic tenet. ACOG’s little "guideline" paper on VBAC in 2004 where the word readily was changed to immediately has had the chilling effect of doing away with VBAC options at hundreds of hospitals. Not due to patient safety, or the ideal of giving true informed consent but really, let’s be honest, due to fear of litigation. I have seen how patients have become counseled by obstetricians at facilities where VBAC has been banned. They are clearly given a skewed view of the risks of VBAC but rarely told of the risks of multiple surgeries. If you think this is untrue you are, sadly, out of touch with real clinical medicine.As to out of hospital birthing, please give me the courtesy of an explanation as to the evidenced-based data you used and the process by which an organization which is supposed to represent me came to this conclusion. Any statement saying that it is as simple as patient safety and that one-size fits all hospital births under the "obstetric model" of practice should be applied to all patients is, putting it nicely, not really in line with what best serves all our patients. In many instances, hospitals are not safe, certainly not nurturing and have a far worse track record for disasters than home birth. Even when emergency help is nearby this is true. The focus of all of us in medicine should be on reigning in trial lawyers and tort reform and lobbying Congress for that. The best interest of the college members and the patients we serve would be for my organization to spend its time and energy on something that has true benefit. Removing choices from well-informed patients and caring doctors and midwives is wholly un-American. So please send me detailed information on how ACOG decided outlawing home birth would be a wise thing to do. You must have conclusive scientific data to take such a drastic stand. Please make it available to me so that I may share it with likeminded colleagues. I would also like to know the process by which this came to pass. Who first raised this issue and why? What committee reviewed all the data and did its due diligence in interviewing those of us with longstanding experience in backing midwives who perform out of hospital births. There must be a clear and concise, non-confidential paper trail you can share with your members. Specific names of committee members who voted for this would be enlightening and I am requesting this information. I would like to know the background and expertise regarding out of hospital birth for each member who had a hand in the decision to go to the AMA.We live in an odd era where once something is said or recommended by a legitimate organization such as ACOG it has deep ramifications never intended such as becoming fodder for trial lawyers trying to squeeze the lifeblood and dignity out of your members. In this case these ramifications have had the undesirable effect of forcing women to travel hundreds of miles in labor to find a supportive facility. Or even worse, to have them arrive in a VBAC banned hospital and refuse surgery or be coerced into it. Can this be the best we can do for our patients? Remember, your VBAC statement was meant to be only a recommendation but quickly became the rule by which hospital administrators, risk managers and anesthesia departments of smaller hospital banned this option for thousands of women. An option, which in proper hands, was the safe and accepted standard of care for 30 years. In fact, you still have an ACOG VBAC brochure that recommends this option! For those of us working at smaller hospitals where VBAC was banned due to lack of emergency help (anesthesia, OR crews, etc.) there is a big question that has perplexed us that no administrator seems to be willing or able to answer. That question is: "If a hospital cannot handle an emergency c/section for VBACs, and most obstetrical emergencies are for fetal bradycardia, hemorrhage (i.e. abruption) or shoulder dystocia not for ruptured uteri, then how can they do obstetrics at all?" For they seem to still be able to have a maternity ward without in house anesthesia. Will someday ACOG, in their great wisdom but seeming disconnect from reality, make a "recommendation" that little hospitals unable to afford 24-hour coverage stop providing obstetric services all together? Will this better serve women and their communities throughout America? I am frightened and angered by what you have done in my name. Now I ask you to defend your position in encouraging the AMA to lobby Congress for another restriction on the freedom of choice that belongs to women and their families. Those choices include midwifery and the right to have the most beautiful and life changing event occur wherever best fits their desire. I am baffled that my college thinks this should be a criminal act. Midwives are well trained and required to have obstetrical backup. They have very special relationships with their patients and want the very best outcomes for them. They do not need me or you to police them. We have a habit in out country over the past 40 years of thinking we can legislate out stupidity. All that has done is erode the individual freedoms that belong, by birthright, to each of us. I would hope you trust your Fellows to know their specialty, their colleagues, and what is best for the patient as an individual. These decisions do not belong to politicians or faceless committees. You should have more faith in your members to give balanced informed consent. Again, my recommendation to you is to put all your considerable energy into changing our legal malpractice system. Those of us actually practicing medicine and caring for patients know this to be the greatest threat to the mission and responsibility we have chosen to undertake.I look forward to your response and possibly the beginning of a meaningful dialogue.
Sincerely,Stuart J. Fischbein,
MD FACOGMedical Advisor,
Birth Action Coalition

To read the responses and follow on messages, click on the link above.

Non-pharmaceutical intervention for staying Healthy

http://www.naturallyhealthy.org/blog/
by: Shonda Parker

A great Article on a timely subject - in this fear of flu and disease time we are living in right now, Shonda Parker reminds us of some natural things we can do to give ourselves the best chance to stay healthy.

In times of pandemic disease...

In light of the recent Swine Flu outbreak, some people are thinking where should I go, if I were having a baby today? Would I want to go to my local hospital, where sick and ill people are being treated for various infectious diseases??? Below is a link to an article on this topic... It is certainly something to think about.

http://homebirthishealthy.blogspot.com/2009/04/what-if-buzz-on-social-networks.html

The Other Side of the Glass... (trailer)

http://www.youtube.com/watch?v=wVf4rzam0Xo

I just came across this video (film trailer), on fathers and baby's at birth and the effect of many of the procedures that are done in our modern society.

It is quite interesting. I wish that more people would think about the needs of the newborn and the new family right at birth, to help it remain a respectful and gentle time...

I wonder how hard it is to get the Actual film.

Maternity Care Beware... Quiz

http://www.consumerreports.org/health/medical-conditions-treatments/pregnancy-childbirth/maternity-care/maternity-care-quiz/maternity-care-quiz.htm

Consumer reports - 10 OTC drugs to avoid in pregnancy

http://www.consumerreports.org/health/prescription-drugs/10-over-the-counter-drugs-to-avoid-during-pregnancy/overview/10-over-the-counter-drugs-to-avoid-during-pregnancy-ov.htm