A yummy way to help boost your milk supply...
Ingredients
1 C butter
1 C sugar
1 C brown sugar
4 T water
2 T flaxseed meal (no subs)
2 Lg eggs
1 t vanilla
2 C flour
1 t baking soda
1 t salt
3 C Thick cut oats
1 C Chocolate chips
2 T to 4T Brewers Yeast (no substitutions)
Preparation
Preheat oven at 375.
Mix 2 T of flaxseed meal and water, set aside 3-5 minutes.
Cream butter and sugar.
Add eggs or vegan substitutes.
Stir flaxseed mix into butter mix and add vanilla.
Beat until well blended.
Sift: dry ingredients, except oats and choc chips.
Add butter mix to dry ingredients.
Stir in the oats and then the choc chips.
Drop on parchment paper on baking sheet.
Bake 8-12 minutes
Friday, February 5, 2010
Friday, January 29, 2010
Babies who are Breastfed as Infants Make Better Teens
After conducting an extensive study, which has managed to reveal that there is a link between breastfeeding and a child's mental health, researchers are now urging mothers to breastfeed their new-born, at least till the age of 6 months.
The large-scale study followed about 3,000 women for a long period of 14 years, across Western Australia. The researchers tracked the development of children of these women from the time they were infants to when they hit early adolescence.
Out of all women participating in the study, some had breastfed for varying lengths of time, and some had not done so at all. Analysis of the data thus collected helped researchers reach the hypothesis of the study.
"What we found was that for each additional month that a child was breastfed [the] behavior in teenagers improved. We can say clearly that breastfeeding for six months or longer is positively associated with mental health and wellbeing in children and adolescents", said Sven Silburn from the Menzies School of Health Research, one of the researchers.
Details of the study have been study published in the Journal of Paediatrics.
The large-scale study followed about 3,000 women for a long period of 14 years, across Western Australia. The researchers tracked the development of children of these women from the time they were infants to when they hit early adolescence.
Out of all women participating in the study, some had breastfed for varying lengths of time, and some had not done so at all. Analysis of the data thus collected helped researchers reach the hypothesis of the study.
"What we found was that for each additional month that a child was breastfed [the] behavior in teenagers improved. We can say clearly that breastfeeding for six months or longer is positively associated with mental health and wellbeing in children and adolescents", said Sven Silburn from the Menzies School of Health Research, one of the researchers.
Details of the study have been study published in the Journal of Paediatrics.
Monday, January 25, 2010
Hypnobabies Homestudy Course Drawing
Check out this blog - she is hosting a give away for the Hypnobabies Homestudy Course. I have only heard great things about this course. Hurry up and enter!
Sunday, January 24, 2010
Pot smoking during pregnancy may stunt fetal growth
NEW YORK (Reuters Health) - Women who smoke marijuana during pregnancy may impair their baby's growth and development in the womb, a new study suggests.
Poor fetal growth and reduced head circumference at birth are linked to an increased risk of problems with thinking, memory and behavior in childhood. Cigarette smoking during pregnancy is known to impair fetal growth, but studies on the potential effects of marijuana have been inconclusive.
For the new study, researchers in the Netherlands followed more than 7,000 pregnant women, 3 percent of whom acknowledged smoking marijuana at least during early pregnancy. They found that babies born to marijuana users tended to weigh less and have smaller heads than other infants.
What's more, the study found, the longer a woman had used marijuana during pregnancy, the stronger the impact on birth size -- suggesting that the drug itself was to blame.
And while most marijuana users in the study also smoked cigarettes, the drug appeared to have effects over and above those of tobacco. In fact, marijuana showed stronger effects on birth size than tobacco, the investigators report in the Journal of the American Academy of Child and Adolescent Psychiatry.
The findings suggest that marijuana use, even restricted to early pregnancy, may have irreversible effects on fetal growth, write the researchers, led by Hannan El Marroun of Erasmus University Medical Center in Rotterdam.
To prevent this, they add, women who smoke marijuana should quit before becoming pregnant.
The study included almost 7,500 pregnant women who were surveyed on their use of alcohol, tobacco and drugs, and had ultrasounds to chart fetal growth during the first, second and third trimesters.
Overall, 214 women said they had used marijuana before and during early pregnancy; 81 percent quit after learning they were pregnant, but 41 women continued to smoke marijuana throughout pregnancy.
The researchers found that, on average, marijuana users gave birth to smaller babies, particularly those who had used throughout pregnancy.
Women who had smoked only during early pregnancy had babies who were
156 grams -- about 5.5 ounces -- lighter than infants born to women who had not used the drug. Women who had continued to smoke past early pregnancy had babies who were 277 grams, or nearly 10 ounces, smaller.
Based on ultrasound, marijuana use only in early pregnancy impaired fetal growth by about 11 grams per week, while use throughout pregnancy slowed fetal growth by roughly 14 grams per week. That compared with a deficit of 4 grams per week with tobacco use, the researchers found.
Similar patterns were seen when the researchers looked at fetal head circumference.
According to El Marroun's team, mothers' marijuana use could stunt fetal growth for several reasons. Like tobacco smoking, it may deprive the fetus of oxygen. It is also possible that the byproducts of marijuana directly affect the developing nervous and hormonal systems of the fetus.
Finally, the researchers note, pregnant women who use marijuana may have other factors in their lives - such as a less-than-healthy diet or chronic stress -- that could contribute to poor fetal growth.
SOURCE: Journal of the American Academy of Child and Adolescent Psychiatry, December 2009.
Poor fetal growth and reduced head circumference at birth are linked to an increased risk of problems with thinking, memory and behavior in childhood. Cigarette smoking during pregnancy is known to impair fetal growth, but studies on the potential effects of marijuana have been inconclusive.
For the new study, researchers in the Netherlands followed more than 7,000 pregnant women, 3 percent of whom acknowledged smoking marijuana at least during early pregnancy. They found that babies born to marijuana users tended to weigh less and have smaller heads than other infants.
What's more, the study found, the longer a woman had used marijuana during pregnancy, the stronger the impact on birth size -- suggesting that the drug itself was to blame.
And while most marijuana users in the study also smoked cigarettes, the drug appeared to have effects over and above those of tobacco. In fact, marijuana showed stronger effects on birth size than tobacco, the investigators report in the Journal of the American Academy of Child and Adolescent Psychiatry.
The findings suggest that marijuana use, even restricted to early pregnancy, may have irreversible effects on fetal growth, write the researchers, led by Hannan El Marroun of Erasmus University Medical Center in Rotterdam.
To prevent this, they add, women who smoke marijuana should quit before becoming pregnant.
The study included almost 7,500 pregnant women who were surveyed on their use of alcohol, tobacco and drugs, and had ultrasounds to chart fetal growth during the first, second and third trimesters.
Overall, 214 women said they had used marijuana before and during early pregnancy; 81 percent quit after learning they were pregnant, but 41 women continued to smoke marijuana throughout pregnancy.
The researchers found that, on average, marijuana users gave birth to smaller babies, particularly those who had used throughout pregnancy.
Women who had smoked only during early pregnancy had babies who were
156 grams -- about 5.5 ounces -- lighter than infants born to women who had not used the drug. Women who had continued to smoke past early pregnancy had babies who were 277 grams, or nearly 10 ounces, smaller.
Based on ultrasound, marijuana use only in early pregnancy impaired fetal growth by about 11 grams per week, while use throughout pregnancy slowed fetal growth by roughly 14 grams per week. That compared with a deficit of 4 grams per week with tobacco use, the researchers found.
Similar patterns were seen when the researchers looked at fetal head circumference.
According to El Marroun's team, mothers' marijuana use could stunt fetal growth for several reasons. Like tobacco smoking, it may deprive the fetus of oxygen. It is also possible that the byproducts of marijuana directly affect the developing nervous and hormonal systems of the fetus.
Finally, the researchers note, pregnant women who use marijuana may have other factors in their lives - such as a less-than-healthy diet or chronic stress -- that could contribute to poor fetal growth.
SOURCE: Journal of the American Academy of Child and Adolescent Psychiatry, December 2009.
Birth Drugs Impair Breastfeeding
Sunday, January 24, 2010 by: David Gutierrez
(NaturalNews) Drugs commonly given during hospital labor may impair a woman's ability to breastfeed, according to a study conducted by researchers from Swansea University and published in the journal BJOG.
"A lot of women are not given enough information about the medications that might be given to them during childbirth, and women at low risk of bleeding may not need to take these drugs," said Rosemary Dodds of the National (British) Childbirth Trust, who was not involved in the study. "It is important that women understand the risks and can give their informed consent before they go into labor."
Researchers examined data from 45,000 births in South Wales, finding that women who were given either oxytocin (also marketed as pitocin and syntocinon) or ergometrine (also known as ergonovine) were significantly less likely to begin breastfeeding within 48 hours of birth than women who were not given the drugs.
Oxytocin and ergometrine are regularly given to women in order to reduce their risk of postpartum hemorrhaging, even when the risk is already low. Oxytocin is also used in labor in order to stimulate contractions, but this use was not examined in the current study.
Among women who had not been given either drug following the delivery of their child, 65.5 percent began breastfeeding within 48 hours. Among women who had received oxytocin, only 59.1 percent did so, while only 54.6 percent of women who received both drugs began breastfeeding within 2 days.
The researchers suggested that the anti-bleeding drugs could interfere with milk production, thus making breastfeeding more difficult and causing new mothers to give up in frustration.
The study also found that high doses of painkillers known as epidurals also reduce a woman's chance of breastfeeding. Prior studies have also found this connection.
Breastfeeding has been linked to a number of significant lifelong health benefits for both mothers and infants.
Sources for this story include: news.bbc.co.uk.
(NaturalNews) Drugs commonly given during hospital labor may impair a woman's ability to breastfeed, according to a study conducted by researchers from Swansea University and published in the journal BJOG.
"A lot of women are not given enough information about the medications that might be given to them during childbirth, and women at low risk of bleeding may not need to take these drugs," said Rosemary Dodds of the National (British) Childbirth Trust, who was not involved in the study. "It is important that women understand the risks and can give their informed consent before they go into labor."
Researchers examined data from 45,000 births in South Wales, finding that women who were given either oxytocin (also marketed as pitocin and syntocinon) or ergometrine (also known as ergonovine) were significantly less likely to begin breastfeeding within 48 hours of birth than women who were not given the drugs.
Oxytocin and ergometrine are regularly given to women in order to reduce their risk of postpartum hemorrhaging, even when the risk is already low. Oxytocin is also used in labor in order to stimulate contractions, but this use was not examined in the current study.
Among women who had not been given either drug following the delivery of their child, 65.5 percent began breastfeeding within 48 hours. Among women who had received oxytocin, only 59.1 percent did so, while only 54.6 percent of women who received both drugs began breastfeeding within 2 days.
The researchers suggested that the anti-bleeding drugs could interfere with milk production, thus making breastfeeding more difficult and causing new mothers to give up in frustration.
The study also found that high doses of painkillers known as epidurals also reduce a woman's chance of breastfeeding. Prior studies have also found this connection.
Breastfeeding has been linked to a number of significant lifelong health benefits for both mothers and infants.
Sources for this story include: news.bbc.co.uk.
Saturday, January 23, 2010
No need for pregnant women to fast during labor
This one seems like an obvious one, but I guess it takes a medical review to confirm it. At home, we encourage you to eat as you desire. How can you expect to run the marathon of labor, if you are not well nourished?
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.
Dr. Jennifer Milosavljevic, a specialist in obstetrics and gynecology at Henry Ford Health System, Detroit, who was not involved in the Cochrane Review, agrees that pregnant women should be allowed to eat and/or drink during labor.
"In my experience," she told Reuters Health in an email, "most pregnant patients at Henry Ford are placed on a clear liquid diet during labor which includes water, apple juice, cranberry juice, broth, and jello. If a patient is brought in for a prolonged induction of labor, she will typically be permitted to eat a regular diet and order anything off the menu in between different induction modalities."
Milosavlievic has "not seen any adverse outcomes by allowing women the option of liquids and/or a regular diet in labor."
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.
"As for the continued restriction on food, the reality is that eating is the last thing most women are going to want to do since nausea and vomiting during labor is quite common," Dr. William H. Barth, Jr., chair of ACOGs Committee on Obstetric Practice, noted in a written statement at the time.
But based on the evidence, Mandisa Singata of the East London Hospital Complex in East London, South Africa, an author on the new Cochrane Review, says "women should be able to make their own decisions about whether they want to eat or drink during labor, or not."
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.
The researchers emphasize that they did not find any studies that assessed the risks of eating and drinking for women with a higher risk of needing anesthesia and so further research is need before specific recommendations can be made for this group.
SOURCE: Cochrane Library, 2010.
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.
Dr. Jennifer Milosavljevic, a specialist in obstetrics and gynecology at Henry Ford Health System, Detroit, who was not involved in the Cochrane Review, agrees that pregnant women should be allowed to eat and/or drink during labor.
"In my experience," she told Reuters Health in an email, "most pregnant patients at Henry Ford are placed on a clear liquid diet during labor which includes water, apple juice, cranberry juice, broth, and jello. If a patient is brought in for a prolonged induction of labor, she will typically be permitted to eat a regular diet and order anything off the menu in between different induction modalities."
Milosavlievic has "not seen any adverse outcomes by allowing women the option of liquids and/or a regular diet in labor."
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.
"As for the continued restriction on food, the reality is that eating is the last thing most women are going to want to do since nausea and vomiting during labor is quite common," Dr. William H. Barth, Jr., chair of ACOGs Committee on Obstetric Practice, noted in a written statement at the time.
But based on the evidence, Mandisa Singata of the East London Hospital Complex in East London, South Africa, an author on the new Cochrane Review, says "women should be able to make their own decisions about whether they want to eat or drink during labor, or not."
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.
The researchers emphasize that they did not find any studies that assessed the risks of eating and drinking for women with a higher risk of needing anesthesia and so further research is need before specific recommendations can be made for this group.
SOURCE: Cochrane Library, 2010.
Friday, January 22, 2010
Why Rearfacing is Better
Just came across this blog on extended rearfacing - I love how all the info is in this one place.
We keep our kids rearfacing until they are around 3 - because it is all they know, there are no arguments about it. If they want to ride in the car, which is non negotiable, they must be properly restrained.
We keep our kids rearfacing until they are around 3 - because it is all they know, there are no arguments about it. If they want to ride in the car, which is non negotiable, they must be properly restrained.
Study finds breast milk has longer shelf life than previously thought
January 2, 2010 By Delthia Ricks
Breast milk can be safely stored in a refrigerator for four days without the threat of bacterial contamination or loss of nutritional value, Long Island scientists have found in a groundbreaking study.
The small research project at Schneider Children's Hospital of the North Shore-Long Island Jewish Health System essentially asked a question that had not been asked before: Can breast milk remain potent and germ-free for four days?
Prior to the analysis, which involved 36 new mothers whose premature babies were being treated in the neonatal intensive care unit, doctors at most hospitals would not allow the milk to remain in storage for more than 72 hours.
Dr. Richard Schanler, chief of neonatal medicine at Schneider Children's Hospital, said there were even stricter rules at his institution.
"We didn't like to store it longer than 48 hours and that prompted us to do this study, and we found there really weren't many changes (in nutritional integrity or bacterial presence) up to 96 hours," he said.
He hopes the discovery will lead to a paradigm shift for hospitals everywhere.
Human milk management and storage are huge concerns in neonatal intensive care units, Schanler said. Previous studies have addressed these issues, but they mostly focused on the amount of bacteria in stored milk.
Although the new research focused on hospital milk storage, Schanler said it also is relevant for working moms who must balance infant feedings and a job away from home.
The research, which suggests maintaining human milk in glass containers or plastic ones free of bisphenol A (BPA), is reported in the January issue of The Journal of Pediatrics. Schanler and his colleagues recommend a temperature of 39 degrees Fahrenheit, or cooler, and placing milk in the rear of the refrigerator.
He said the analysis was designed to answer many of the pressing questions about milk storage and usage in neonatal intensive care units where premature infants are treated. New moms must routinely pump milk for feedings and the milk is refrigerated.
Freezing has been an additional approach. But the freezing of breast milk causes the destruction of key infection-fighting cells that can protect the milk from bacterial colonization, Schanler said. There also are nutritional losses when breast milk is frozen.
"Certain immune components, proteins and enzymes are decreased in frozen milk," Schanler said.
The Human Milk Banking Association of North America has suggested that human milk remains viable refrigerated for up to eight days, but that long-term storage raises serious health questions in hospitals.
Schanler and Dr. Meredith Slutzah, also of Schneider Children's Hospital, tackled the storage issue because there were questions beyond that of bacteria, such as human milk's nutritional value.
In the study, scientists from Schneider's and Yeshiva University's Albert Einstein College of Medicine required the mothers to collect milk with a breast pump. Researchers stored the milk at 39 degrees Fahrenheit and tested it after 24, 48, 72 and 96 hours. Even after the 96 hours, there was virtually no bacterial contamination, Schanler said, because the other components in the milk remained viable.
Breast milk can be safely stored in a refrigerator for four days without the threat of bacterial contamination or loss of nutritional value, Long Island scientists have found in a groundbreaking study.
The small research project at Schneider Children's Hospital of the North Shore-Long Island Jewish Health System essentially asked a question that had not been asked before: Can breast milk remain potent and germ-free for four days?
Prior to the analysis, which involved 36 new mothers whose premature babies were being treated in the neonatal intensive care unit, doctors at most hospitals would not allow the milk to remain in storage for more than 72 hours.
Dr. Richard Schanler, chief of neonatal medicine at Schneider Children's Hospital, said there were even stricter rules at his institution.
"We didn't like to store it longer than 48 hours and that prompted us to do this study, and we found there really weren't many changes (in nutritional integrity or bacterial presence) up to 96 hours," he said.
He hopes the discovery will lead to a paradigm shift for hospitals everywhere.
Human milk management and storage are huge concerns in neonatal intensive care units, Schanler said. Previous studies have addressed these issues, but they mostly focused on the amount of bacteria in stored milk.
Although the new research focused on hospital milk storage, Schanler said it also is relevant for working moms who must balance infant feedings and a job away from home.
The research, which suggests maintaining human milk in glass containers or plastic ones free of bisphenol A (BPA), is reported in the January issue of The Journal of Pediatrics. Schanler and his colleagues recommend a temperature of 39 degrees Fahrenheit, or cooler, and placing milk in the rear of the refrigerator.
He said the analysis was designed to answer many of the pressing questions about milk storage and usage in neonatal intensive care units where premature infants are treated. New moms must routinely pump milk for feedings and the milk is refrigerated.
Freezing has been an additional approach. But the freezing of breast milk causes the destruction of key infection-fighting cells that can protect the milk from bacterial colonization, Schanler said. There also are nutritional losses when breast milk is frozen.
"Certain immune components, proteins and enzymes are decreased in frozen milk," Schanler said.
The Human Milk Banking Association of North America has suggested that human milk remains viable refrigerated for up to eight days, but that long-term storage raises serious health questions in hospitals.
Schanler and Dr. Meredith Slutzah, also of Schneider Children's Hospital, tackled the storage issue because there were questions beyond that of bacteria, such as human milk's nutritional value.
In the study, scientists from Schneider's and Yeshiva University's Albert Einstein College of Medicine required the mothers to collect milk with a breast pump. Researchers stored the milk at 39 degrees Fahrenheit and tested it after 24, 48, 72 and 96 hours. Even after the 96 hours, there was virtually no bacterial contamination, Schanler said, because the other components in the milk remained viable.
Thursday, January 21, 2010
Elective cesarean sections are too risky, WHO study says
By Katherine Harmon
Despite medical advances and increasing access to improved obstetric care across the globe, surgical childbirths are still more risky for both mother and baby, according to an ongoing international survey by the World Health Organization (WHO).
A new report from the survey, which was published online today in the medical journal The Lancet, found that in Asia—in both developed and developing nations—cesarean section births only reduced risks of major complications for mother and child if they were medically recommended. Elected surgical deliveries, on the other hand, put both at greater risk.
"Cesarean section should be done only when there is a medical indication to improve the outcome for the mother or the baby," the authors of the report concluded. Common reasons for a recommendation for cesarean delivery included a previous cesarean section, cephalopelvic disproportion (when the baby's head cannot fit through the mother's pelvic opening) and fetal distress.
In the nine countries studied (Cambodia, China, India, Japan, Nepal, the Philippines, Sri Lanka, Thailand and Vietnam), more than a quarter of the 107,950 births analyzed (27.3 percent) were C-sections, and in China, which had the highest rate of operations, nearly half (46.2 percent) of the births in the survey were cesarean. With these surgeries comes increased risk of maternal death, infant death, admission into an intensive care unit, blood transfusion, hysterectomy or internal iliac artery ligation (to control bleeding in the pelvis) compared to spontaneous vaginal delivery, according to the report.
But these risks have not necessarily been absorbed into popular, or even medical culture. The rates of cesarean section procedures are on the rise in many countries across the globe, the authors report, and in some countries they "have reached epidemic proportions." Among the nations studied, China had the highest rate of cesarean sections that were performed without medical indication—11.7 percent; the overall rate for the facilities studied had a rate of 1.9 percent.
Most cesarean sections (15.8 percent of births) were begun during labor, as opposed to before it starts. But these later procedures—both elected (0.5 percent) and medically required (15.3 percent)—also carry the most risks for adverse outcomes, the authors found.
In a commentary accompanying the report, Yap-Seng Chong of the National University of Medicine in Singapore and Kenneth Y C Kwek of the KK Women's and Children's Hospital also in Singapore call the results "surprising and chilling." The findings, they say "should help us to prioritize our strategies to reduce unnecessary interventions in childbirth," they wrote. "There is little wrong with medical interventions when indicated, but for those who are still inclined to consider caesarean delivery a harmless option, they need to take a cold hard look at the evidence against unnecessary cesarean section."
The investigators were able to analyze some 96 percent of the births reported in the 122 hospitals that participated in the survey over two to three months between 2007 and 2008. Facilities were located in the capital city of each country and two randomly chosen regions. To qualify for the survey, hospitals had to be delivering at least 1,000 babies a year and performing cesarean surgeries, so as the authors noted, "the results therefore cannot be generalized to smaller facilities" or to the countries overall.
Despite the increased risks associated with cesarean deliveries, no mothers or babies in the study died after an elected cesarean before hospital release. The most dangerous form of childbirth proved to be vaginal operative delivery, which includes using forceps or a vacuum to assist in delivery and is more rare, occurring in just 3.2 percent of the births analyzed.
The findings confirm a previous WHO report published in 2006 in The Lancet, analyzing the rates and safety of various childbirth approaches in Latin America, where the investigators found that "increasing rates of cesarean section do not necessarily lead to improved outcomes and could be associated with harm." Taking the two reports together, the authors concluded, lends "strong multiregional support for the recommendation of avoiding unnecessary cesarean sections."
Surgical childbirth also requires more resources than a natural vaginal delivery, the authors note. Especially in countries where money, medical practitioners or proper equipment is more limited, unnecessary cesarean sections can drain resources away from those cases in which it can improve the chances of a healthy mother and baby.
http://www.scientificamerican.com/blog/post.cfm?id=elective-cesarean-sections-are-too-2010-01-11
Despite medical advances and increasing access to improved obstetric care across the globe, surgical childbirths are still more risky for both mother and baby, according to an ongoing international survey by the World Health Organization (WHO).
A new report from the survey, which was published online today in the medical journal The Lancet, found that in Asia—in both developed and developing nations—cesarean section births only reduced risks of major complications for mother and child if they were medically recommended. Elected surgical deliveries, on the other hand, put both at greater risk.
"Cesarean section should be done only when there is a medical indication to improve the outcome for the mother or the baby," the authors of the report concluded. Common reasons for a recommendation for cesarean delivery included a previous cesarean section, cephalopelvic disproportion (when the baby's head cannot fit through the mother's pelvic opening) and fetal distress.
In the nine countries studied (Cambodia, China, India, Japan, Nepal, the Philippines, Sri Lanka, Thailand and Vietnam), more than a quarter of the 107,950 births analyzed (27.3 percent) were C-sections, and in China, which had the highest rate of operations, nearly half (46.2 percent) of the births in the survey were cesarean. With these surgeries comes increased risk of maternal death, infant death, admission into an intensive care unit, blood transfusion, hysterectomy or internal iliac artery ligation (to control bleeding in the pelvis) compared to spontaneous vaginal delivery, according to the report.
But these risks have not necessarily been absorbed into popular, or even medical culture. The rates of cesarean section procedures are on the rise in many countries across the globe, the authors report, and in some countries they "have reached epidemic proportions." Among the nations studied, China had the highest rate of cesarean sections that were performed without medical indication—11.7 percent; the overall rate for the facilities studied had a rate of 1.9 percent.
Most cesarean sections (15.8 percent of births) were begun during labor, as opposed to before it starts. But these later procedures—both elected (0.5 percent) and medically required (15.3 percent)—also carry the most risks for adverse outcomes, the authors found.
In a commentary accompanying the report, Yap-Seng Chong of the National University of Medicine in Singapore and Kenneth Y C Kwek of the KK Women's and Children's Hospital also in Singapore call the results "surprising and chilling." The findings, they say "should help us to prioritize our strategies to reduce unnecessary interventions in childbirth," they wrote. "There is little wrong with medical interventions when indicated, but for those who are still inclined to consider caesarean delivery a harmless option, they need to take a cold hard look at the evidence against unnecessary cesarean section."
The investigators were able to analyze some 96 percent of the births reported in the 122 hospitals that participated in the survey over two to three months between 2007 and 2008. Facilities were located in the capital city of each country and two randomly chosen regions. To qualify for the survey, hospitals had to be delivering at least 1,000 babies a year and performing cesarean surgeries, so as the authors noted, "the results therefore cannot be generalized to smaller facilities" or to the countries overall.
Despite the increased risks associated with cesarean deliveries, no mothers or babies in the study died after an elected cesarean before hospital release. The most dangerous form of childbirth proved to be vaginal operative delivery, which includes using forceps or a vacuum to assist in delivery and is more rare, occurring in just 3.2 percent of the births analyzed.
The findings confirm a previous WHO report published in 2006 in The Lancet, analyzing the rates and safety of various childbirth approaches in Latin America, where the investigators found that "increasing rates of cesarean section do not necessarily lead to improved outcomes and could be associated with harm." Taking the two reports together, the authors concluded, lends "strong multiregional support for the recommendation of avoiding unnecessary cesarean sections."
Surgical childbirth also requires more resources than a natural vaginal delivery, the authors note. Especially in countries where money, medical practitioners or proper equipment is more limited, unnecessary cesarean sections can drain resources away from those cases in which it can improve the chances of a healthy mother and baby.
http://www.scientificamerican.com/blog/post.cfm?id=elective-cesarean-sections-are-too-2010-01-11
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