TIME is On Our Side

Check out the article in Time Magazine!
... and be sure to read the "story behind the story" at The Huffington Post

Does this effect women in WNY? Yes it does!

According to the New York State Department of Health, as well as a survey taken by ICAN volunteers says that women in Niagara and OrleansCounties show that three out of the four hospitals with maternity units do NOT offer VBAC as an option for their mothers. These three hospitals are Niagara Falls Memorial, Medina Memorial and Inter-Community Hospital in Newfane. One other hospital, Mount St. Mary's in Lewiston does claim to offer VBAC as an option, but only 3.4% of women who've had a previous c-section are having them there. These hospitals only handled a total of 1,000 births in 2007, but of that, but it means around 160 women may have been sectioned unnecessarily, subjecting them to unnecessary risk.

What about the women of Erie County? While there are no bans at Women and Children's hospital, Millard Fillmore Suburban, Sisters or Mercy hospital, the rates of women who are having VBACs is on the decline from an overall percentage of 12% in 2006 to 9% in 2007. The most disturbing is Mercy, who is according to the DOH site has a 5.6% VBAC rate, but none of our hospitals are performing up to par.

Cesarean rates at all of these hospitals are high, though this year some have shown minor declines. Overall in Erie county, about 34% percent of women will have the surgery that Consumer Reports has listed as one of the top surgeries you're better off without, and this is up from 33.4% from 2006.

Is this because women are asking for cesareans? Or, could it be that women aren't being well-informed of their choices? Women don't want to talk about the risks because it is too "scary", but we need to start facing what the real possibilities are before making such important decisions.

Journey to Breech VBA2C

Here is one of our ICAN mama's journeys to having a breech VBAC after two cesareans:

Photo and video editing at www.OneTrueMedia.com

History of Midwives

The fear of copyright infringement precludes me from publishing this article in it's entirity. If you choose to follow just one link from this blog ever, this is a really good one to choose. Some highlights:

History of midwives
ST. LOUIS POST-DISPATCH
01/19/2008

In the 1930s, maternal mortality rates began to decline in hospitals in the U.S. thanks to the use of more sterile surgical conditions and techniques. Medical advances in antibiotics and blood transfusions accelerated declines. Around this time, medical doctors began campaigning against midwives in the media, courts and legislature. They cited poor outcomes, though some research suggests they were ridding their competition.

Technologically intensive childbirth, however, has become the norm. The rate of labor induction has doubled since 1990, which studies show increases the chances of having a Cesarean section. The C-section rate has jumped within the past 10 years to over 30 percent, the highest ever. The major abdominal surgery involves risk to the mother and also increases risk of complications in subsequent pregnancies.

A comprehensive survey of women’s childbearing experiences released last year shows most mothers experienced each of the following during labor and delivery — continuous electronic fetal monitoring, one or more vaginal exams, intravenous fluids, epidural or spinal analgesia and a catheter. Most had little understanding of the side effects of these interventions. The survey also showed that many received interventions, such as episiotomies, without their consent.

National health statistics show that while over 4 million women give birth a year, obstetric procedures number nearly 7 million.

Today, more than 7,000 nurse midwives practice in all 50 states and attend almost 10 percent of all births, mostly in hospitals.

But natural birth advocates decry the loss of non-nurse midwives. As a result, they say women have lost the knowledge and confidence in giving birth. Advocates are pushing for the legalization of non-nurse midwives with specific training in home births. These "direct-entry" midwives learn midwifery through apprenticeship or a midwifery school that is distinct from nursing.

Cesareans: Twice the Risk

Excerpt from:
http://www.nlm.nih.gov/medlineplus/news/fullstory_56908.html
Reuters Health

Wednesday, October 31, 2007

NEW YORK (Reuters Health) - Compared with vaginal deliveries, cesarean deliveries have twice the risk of complications and deaths of both infants and mothers when the fetus is in the normal, head-down position, according to findings from a study conducted in Latin America.

However, if the fetus is turned around - in the breech position - the benefits of cesarean delivery outweigh the risks, Dr. Jose Villar, at the University of Oxford in the UK, and associates report in BMJ Online First.

[For what it's worth, and without having taken a look at this study yet but having read another study regarding the safety of breech births, I wonder how many of the deliveries had care providers who were trained in breech births? There is a technique to this, but many OBs are no longer trained in how to handle this, which may segregate the "safe" breech births from the "risky" ones...]

The rising rates of cesarean deliveries in recent years are not explained by any clear benefits to the baby or mother, the authors note. "There is therefore an urgent need to provide women and care providers with information on the potential individual risks and benefits associated with cesarean delivery."


SOURCE: BMJ Online First, October 31, 2007.


Reuters Health

Healthy Babies! Healthy Moms!

As seen in Having a Baby Today and New Health Digest

Healthy Babies! Healthy Moms!
(8 ways to help you be healthy and low risk during pregnancy, labor, and birth)
By Amy V. Haas, BA, BCCE

Pregnancy can be a wonderful and exciting time of life for most women. However, women in the United States receive very little information about how to stay healthy during pregnancy unless they do a lot of individual research. In fact most women don’t realize there is anything they can do to positively impact their health during pregnancy or prevent a high-risk status, with the exception of prenatal care. While proper prenatal care is important, it is not magic. Obstetricians have time constraints, and receive little or no training in nutrition, exercise, or preventative medicine. Even women who join childbirth classes may receive limited information. Below are 8 ways to help educate you in how to stay healthy and low risk during pregnancy, labor, and birth.

1) Nutrition – If you only did one thing to help yourself stay healthy during pregnancy, good nutrition would be it! It is the single most important factor in having a healthy baby and a healthy mom. Eating well in pregnancy means following the Brewer diet, which consists of 75 – 100 grams of good quality protein per day, from varied sources. Great high protein food sources include: meats, soy products, eggs, dairy, nuts, beans, and seeds. You should also be eating 5 servings of high complex carbohydrates to ensure adequate calories for energy, and an additional source of protein. In fact 1/3rd of you protein should be coming from whole grains. This would include whole grains that are not milled or processed, and will retain the most nutrients, protein, and fiber. Eating dairy, soy, nuts, and bean products, and broccoli will assist in getting enough calcium. Additional healthy foods to include would be whole, fresh fruits, and vegetables, and don’t forget to drink to thirst and salt to taste! But try to avoid desserts and junk food. Organic food sources are highly recommended when available. Think Color and Variety! This will help you obtain all the nutrients your body needs to build a healthy baby. Eating right during pregnancy can help to prevent premature labor and birth, toxemia, placental abruption, gestational diabetes, problems with breast feeding and healing, and many other serious health problems that would place a mom in the high-risk category.

2) Exercise – Pregnancy exercises can help prepare your body for the birth of your baby, by targeting specific muscles used during labor. Regular physical exercise can help to build strength and stamina. It also makes it easier to recover after birth. Check with your care provider as to any physical limitations you may have

3) Education – Educating yourself with regard to all the issues involving pregnancy and birth will help you to make responsible decisions that are right for you and your family. As the authors of A Good Birth, A Safe Birth said, “If you don’t know what your choices are, then you don’t have any!” There are many different types of childbirth classes, and you need to research to find out which one will fit your needs. A good book to help in this search is The Birth Book, by Dr. William Sears, and Martha Sears, RN. Educating yourself well will help you to avoid unnecessary health risks common in birth in the United States today. This would include educating yourself as to the necessity of routine testing and procedures during pregnancy. Before consenting to routine testing or procedures be sure that it is being done for a true medical need or problem. You need to be aware of the risks and benefits of all tests and procedures during pregnancy. Excellent sources of information on this topic include Henci Goer’s book Obstetric Myths vs. Research Realities, and Barbara Katz Rothman’s book The Tentative Pregnancy.

4) Avoidance of Harmful substances – Everyone knows that you should avoid all street drugs during pregnancy so your baby will not be harmed, but there are many other substances that should also be avoided to have a healthy pregnancy. They include tobacco, alcohol, caffeine, pollution, pesticides, household and industrial chemicals, and any medically unnecessary medications, including over-the-counter medications. According the AAP, The PDR, and The FDA there is no drug that is considered safe during pregnancy. Sadly this would also include all medications commonly giving during birth, as they all reach the baby, and can have negative side effects for both the mom and baby. Any medication given to a pregnant or laboring woman should be for a true medical problem only. All prescription medications should be taken to your care provider and checked to see if they are truly necessary during pregnancy, and if there may be a safer medication or a smaller dose might be appropriate. Before taking anything you should always check with your care provider first!

5) Choosing a Birth Attendant wisely – When choosing a Doctor or Midwife to assist at your birth, it is important you choose one who not only matches your birth philosophy, but also respects your right to make choices that are right for you. Be sure to interview all candidates before choosing. Think about what kind of a practice you would be comfortable with. Would you prefer a large practice of doctors or midwives, or a small practice of only one or two care providers? If you discover along the way that you are no longer comfortable with your original choice, it is important to know that you have the right to change care providers. Choosing wisely the first time will create less stress in your life.

6) Choosing your Birth Place Wisely – When choosing where to have your baby it is good to know that home births have been shown to be as safe, if not safer, than hospital births. Think about where you will feel the safest, and most comfortable. If you feel safest in a hospital setting, then that may be a good choice for you. This of course, will depend on your health status. Only low risk women will be accepted for a homebirth. While it is possible to have a healthy natural birth in a hospital setting, it is certainly more difficult.

7) Doulas – Consider hiring a professional labor assistant to help you through your labor. Studies have shown that having a doula can reduce the need for medication, cesarean sections, pitocin to speed up labor, and other interventions common in birth today. It’s also wonderful to have backup for your primary labor support person in the event of a long labor.

8) Birth Plans – Never assume that everyone attending your birth knows what you do and don’t want! Create a birth plan that outlines your ultimate goals and priorities. To do this you will need to educate yourself with regard to all aspects of birth in the United States so that you know what your priorities are.
***

(For More information on each of these topics contact Rochester Birth Network at www.rochesterbirthnetwork.com 585- 234-0022)

Amy V. Haas, BCCE ©2002 -2006

Recommended Reading:

The Birth Book by William Sears, M.D. & Martha Sears, RN
The Thinking Woman’s Guide to a Better Birth by Henci Goer
The Brewer Pregnancy Hotline (The Brewer Diet) by Krebs and Brewer (Available on line at www.blueribbonbaby.org )
Natural Childbirth the Bradley Way by Susan McCutcheon
A Wise Birth by Armstrong & Feldman
A Good Birth, A Safe Birth by Korte & Scaer
Gentle Birth Choices by Barbara Harper
Active Birth by Janet Balaskas
Obstetric Myths vs. Research Realities by Henci Goer
The Tentative Pregnancy by Barbara Katz Rothman
Diary of A Midwife – The Power Of Positive Childbearing by Juliana Van Olphen-Fehr
Ina May’s Guide to Childbirth by Ina May Gaskin

The Mommy Uprising

The Mommy Uprising
Click here to read entire article: http://www.bostonmagazine.com/articles/the_mommy_uprising

They’re fed up with the unwanted C-sections, the endless tests, the dubious interventions, and the scary advice from overworked, malpractice-spooked doctors. And Boston women are shunning the area’s world-class hospitals to go to surprising lengths—and sometimes take big risks—to give birth on their own terms.

By Tina Cassidy, a former staff reporter and editor at the Boston Globe, is the author of Birth: The Surprising History of How We Are Born (Atlantic Monthly Press, $24). She has given birth once, by cesarean, to her son, George.
Originally published in Boston Magazine, December 2006.