Sunday, October 26, 2008

Relactation

This past week, I have been helping a new friend relactate for her 6 week old baby. I am so excited for both of them. The new mom has been so committed to doing what is best for her and her baby and the baby has taken to it like a pro.
Many do not know that relactation or induced lactation is possible - even if you have never nursed before or if it has been months since you last made milk. It takes a lot of commitment and perseverance, but the pay off can be so worth it.
You can read more on relactation at http://www.kellymom.com/bf/adopt/index.html.

Friday, October 24, 2008

60 Minutes Australia Circumcision Segment

For those of you that know me well, you know how opposed I am to RIC (Routine Infant Circumcision). I cannot wait for the day when RIC is outlawed just as FGM (Female Genital Mutilation) is here in the states. I believe if more parents knew and truly understood what happens and what is lost with RIC, they would not sit by and allow this to happen to their innocent baby boys.

For more info on circumcision, check out:

http://www.nocirc.org/

http://www.hyphen.bravehost.com/3reasons.html

http://www.mothering.com/articles/new_baby/circumcision/against-circumcision.html

http://circumcisionquotes.com/description.html

Wednesday, October 22, 2008

Childbirth Education Classes

A new series will be starting on Tuesday, November 5. The past series went had great attendance and went really well.

Class 1: Why natural childbirth?, Nutrition & Exercise
Class 2: Pregnancy, Belly mapping, & Stages of Labor
Class 3: Choosing your care provider, Birth Choices, & Doulas
Class 4: Hospital setting, Interventions, Unexpected situations & your Birth plan
Class 5: Conquering Birth Fears, Relaxation, Coaching & Coping techniques
Class 6: Postpartum period, Breastfeeding, Newborn care, & Baby wearing
These classes are set up in such a way that you can pick and choose which information is most important to you and attend on those days. It is not a traditional classroom setting. It's a comfortable discussion between expectant parents and an experienced childbirth professional on specific topics. Group size is small so there is time to address individual situations and concerns. Come for one night of class or come for them all. Course content focuses on understanding childbirth issues and the benefits and risks of interventions and the importance of choosing the right care provider for you. We will discuss the process of birth as well as how our current societal traditions and expectations affect birth to help you in your decision-making process. Labor coping techniques will be taught in a down-to-earth, hands-on manner incorporating many tried and true methods.
A hand out packet with review information of what we have covered will be included with each class.
Preregistration is highly encouraged as walk-ins will only be permitted if space allows. $40 per couple per class or $200 for the whole series that saves $30 off classes
Please contact Dy Gordon at 435-215-6514 or completebeginnings@gmail.com for more information.

Woman Dies After Undergoing C-Section

http://www.boston.com/news/local/articles/2008/10/22/patient_undergoing_c_section_dies/

For the first time in more than 10 years, a patient at Beth Israel Deaconess Medical Center has died while undergoing a caesarean section, the hospital reported yesterday.
The mother died Friday, and the baby experienced complications but appears to be improving, Dr. Kenneth Sands, the hospital's senior vice president of healthcare quality, said in a brief statement.
"This sad and very rare event appears to relate to an unanticipated complication at the time the baby was delivered by caesarean section," it read.
"We immediately launched an internal review and have reported to the Department of Public Health. This is obviously a very sad and distressing event for our staff . . . who have not experienced a loss like this for over 10 years. We continue to extend our deepest sympathy to the family."
The patient's name and other medical details were not disclosed.
The risk of death from a caesarean section is estimated at fewer than 1 in 2,500, according to information on the hospital's website.
That is significantly more than the roughly 1-in-10,000 risk of death during a vaginal birth.
CAREY GOLDBERG

Tuesday, October 21, 2008

Park Day

We are getting ready to head to the park for the day. We go every Tuesday with our playgroup. It is a great time for the kids to play with other kids and for me to have some adult conversation with like minded mamas.
If you are in the Southern Utah area and are interested in an AP support group, check out http://groups.yahoo.com/group/SouthernUtahAPmoms/

Monday, October 20, 2008

Consumer Reports & Maternity Care

I found this http://www.consumerreports.org/health/medical-conditions-treatments/pregnancy-childbirth/maternity-care/overview/maternity-care.htm over at a good friend's blog. Very interesting stuff!

Back to basics for safer childbirth
Too many doctors and hospitals are overusing high-tech procedures

Noninvasive measures can mean better outcomes for baby and Mom.
When it's time to bring a new baby into the world, there's a lot to be said for letting nature take the lead. The normal, hormone-driven changes in the body that naturally occur during delivery can optimize infant health and encourage the easy establishment and continuation of breastfeeding and mother-baby attachment.
Childbirth without technical intervention can succeed in leading to a good outcome for mother and child, according to a new report.

"Evidence-Based Maternity Care: What It Is and What It Can Achieve," co-authored by Carol Sakala and Maureen P. Corry of the nonprofit Childbirth Connection analyzed hundreds of the most recent studies and systematic reviews of maternity care. The 70-page report was issued collaboratively by Childbirth Connection, the Reforming States Group (a voluntary association of state-level health policymakers), and Milbank Memorial Fund, and released on Oct. 8, 2008.
Overuse of high-tech measures
The report found that, in the U.S., too many healthy women with low-risk pregnancies are being routinely subjected to high-tech or invasive interventions that should be reserved for higher-risk pregnancies. Such measures include:
*Inducing labor. The percentage of women whose labor was induced more than doubled between 1990 and 2005
*Use of epidural painkillers, which might cause adverse effects, including rapid fetal heart rate and poor performance on newborn assessment tests
*Delivery by Caesarean section, which is estimated to account for one-third of all U.S births in 2008, will far exceed the World Health Organization's recommended national rate of 5 to 10 percent
*Electronic fetal monitoring, unnecessarily adding to delivery costs
*Rupturing membranes ("breaking the waters"), intending to hasten onset of labor
*Episiotomy, which is often unnecessary
In fact, the current style of maternity care is so procedure-intensive that 6 of the 15 most common hospital procedures used in the entire U.S. are related to childbirth. Although most childbearing women in this country are healthy and at low risk for childbirth complications, national surveys reveal that essentially all women who give birth in U.S. hospitals have high rates of use of complex interventions, with risks of adverse effects.
The reasons for this overuse might have more to do with profit and liability issues than with optimal care, the report points out. Hospitals and care providers can increase their insurance reimbursements by administering costly high-tech interventions rather than just watching, waiting, and shepherding the natural process of childbirth.
Convenience for health care workers and patients might be another factor. Naturally occurring labor is not limited to typical working hours. Evidence also shows that a disproportionate amount of tech-driven interventions like Caesarean sections occur during weekday "business hours," rather than at night, on weekends, or on holidays.

Underuse of high-touch, noninvasive measures
Many practices that have been proven effective and do little to no harm are underused in today's maternity care for healthy low-risk women. They include:
*Prenatal vitamins
*Use of midwife or family physician
*Continuous presence of a companion for the mother during labor
*Upright and side-lying positions during labor and delivery, which are associated with less severe pain than lying down on one's back
*Vaginal birth (VBAC) for most women who have had a previous Caesarean section
*Early mother-baby skin-to-skin contact
The study suggests that those and other low-cost, beneficial practices are not routinely practiced for several reasons, including limited scope for economic gain, lack of national standards to measure providers' performance, and a medical tradition that doesn't prioritize the measurement of adverse effects, or take them into account.

Quiz: Maternity care, beware

Despite growing evidence of harm, many obstetricians and maternity hospitals still overuse high-tech procedures that can mean poorer outcomes for baby and Mom. Test your knowledge with our quiz below, and then learn more in our report.

1. An obstetrician will deliver better maternity care, overall, than a midwife or family doctor.

False. Studies show that the 8 percent to 9 percent of U.S. women who use midwives and the 6 to 7 percent who choose family physicians generally experienced just-as-good results as those who go to obstetricians. Those who used midwives also ended up with fewer technological interventions. For example, women who received midwifery care were less likely to experience induced labor, have their water broken for them, episiotomies, pain medications, intravenous fluids, and electronic fetal monitoring, and were more likely to give birth vaginally with no vacuum extraction or forceps, than similar women receiving medical care. Note that an obstetric specialist is best for the small proportion of women with serious health concerns.

2. Induced labor can halt fetal development.

True. The vital organs (including the brain and lungs) continue to develop beyond the 37th week of gestation. There is also a five-fold increase in the brain’s white matter volume between 35 and 41 weeks after conception. Inducing labor (with synthetic oxytocin, for example) might stop this growth if the fetus is not fully developed. Between 1990 and 2005, the number of women whose labor was induced more than doubled.

3. Due-date estimates can be off by up to two weeks.

True. This inaccuracy can lead to a baby being delivered by induction or Caesarean section up to two weeks earlier than its estimated due-date, cutting off important weeks of fetal development.

4. “Breaking the waters” helps hasten labor.

False. There is no evidence to support the fact that this common practice (about 47% of women) shortens labor, increases maternal satisfaction, or improves outcomes for newborns.

5. Induced labor increases the likelihood of Caesarean section in first-time mothers.

True. The cervix may not be ready for labor. Other effects of induced labor include an increased likelihood of an epidural, an assisted delivery with vacuum extraction or forceps, and extreme bleeding postpartum.

6. Once you’ve had a C-section, it’s best to do it again.

False. Studies show that, as the number of a woman’s previous C-sections increased, so did the likelihood of harmful conditions, including: trouble getting pregnant again, problems delivering the placenta (placenta accreta), longer hospital stays, intensive-care (ICU) admission, hysterectomy, and blood transfusion.

7.Labor itself can benefit a newborn’s immunity.

True. When babies do not experience labor (if the mother has a C-section before entering into labor, for example), they fail to benefit from changes that help to clear fluid from their lungs. That clearance can protect against serious breathing problems outside the womb. Passage through the vagina might also increase the likelihood that the newborn’s intestines will be colonized with “good” bacteria after the sterile womb environment.

8. Epidural anesthesia is a low-risk way to make labor easier.

False. Many women welcome the pain relief, but might not be well-informed about the increased risk of its side-effects, including lack of mobility, sedation, fever, longer pushing, and serious perineal tears.

9. Epidural anesthesia presents risks to newborns.

True. Babies whose mothers received epidurals during labor are at risk for rapid heart rate, hyperbilirubinemia (the presence of an excess of bilirubin in the blood), need for antibiotics, and poorer performance on newborn assessment tests.

10. Episiotomies reduce the risk of perineal tearing.

False. Evidence shows that routine use of episiotomy offers no benefits but rather increases women’s risk of experiencing perineal injury, stitches, pain and tenderness, leaking stool or gas, and pain during sexual intercourse. Yet in 2005, 25 percent of women with vaginal births continued to experience this intervention. Episiotomy is one of several obstetric practices adopted into common usage before being adequately studied.

Source: “Evidence-Based Maternity Care: What It Is and What It Can Achieve,” a detailed review of clinical evidence by Carol Sakala and Maureen P. Corry published by the Childbirth Connection, the Reforming States Group, and the Milbank Memorial Fund, October 2008.

Infant Mortality Rates in US, Poland and Slovakia

U.S. Infant Mortality Rate Equals that of Poland and Slovakia
By Todd Neale, Staff Writer, MedPage TodayPublished: October 15, 2008
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
HYATTSVILLE, Md., Oct. 15 -- Amid hints that the U.S. infant mortality rate is starting to improve after a five-year plateau, the country continues to slide down the list of developed countries in this key indicator of national health.
The U.S. ranked 29th in 2004, with a rate of 6.78 deaths per 1,000 live births, tied with Poland and Slovakia, Marian MacDorman, Ph.D., and T.J. Mathews, M.S., of the CDC's National Center for Health Statistics here, reported in a data brief.
The U.S. had been ranked 12th in 1960 and 23rd in 1990, the researchers said.
"The gap between the U.S. infant mortality rate and the rates for the countries with the lowest infant mortality appears to be widening," they said.
Japan had the best rate, less than 3 deaths per 1,000 live births.
However, preliminary data showed that the U.S. infant mortality rate declined from 6.86 to 6.71 deaths per 1,000 live births from 2005 to 2006, marking the first drop since 2000.
Racial disparities remained in 2005, the last year with complete data, such that the infant mortality rate for non-Hispanic black women was 2.4 times the rate for non-Hispanic whites (13.63 versus 5.76 deaths per 1,000 live births).
Puerto Rican (8.30) and American Indian or Alaskan Native women (8.06) had above-average rates as well.
The only ethnic group that met the government's Healthy People 2010 target of fewer than 4.5 infant deaths per 1,000 live births was Cubans (4.42).
The researchers said that the disparities may be the result of differences in risk factors for infant mortality, such as preterm and low birth weight delivery, socioeconomic status, and access to medical care, although "many of the racial and ethnic differences in infant mortality remain unexplained."
To explain the plateau in the infant mortality rate from 2000 to 2005, Dr. MacDorman and Mathews pointed to the increase in the percentage of births before 37 weeks gestation -- which carry a higher mortality risk -- from 11.6% to 12.7%.
The rise in preterm births was partially driven by an increase in multiple births resulting from artificial reproductive technologies and in the use of Caesarean delivery or induced labor for mothers with serious medical conditions, according to Dr. MacDorman.

Catching back up...

Life has been a bit crazy these past weeks. So much has happened...
Five gorgeous babies were born in 5 weeks, I took a trip to California for my best friend's wedding, prenatals, postpartums, CBE Classes, my son's birthday and more. For awhile I felt like I was just wading to keep my head above water. Thankfully, life feels like it is slowing down. It is good for me and good for my family.
I encapsulated a placenta for a friend who recently had her baby. What an experience. It wasn't that it was a hard process - just very time consuming. She has been taking them for about a week now and reports feeling the best she has ever felt after the birth of a child - and her bleeding is so much lighter as well. I have decided to offer this as a service for women who want to enjoy the benefits of their placenta without worrying about the encapsulation process themselves. After doing it, I definitely do not think that a new mom should take it on her self. I have pictures of the process that I am going to post as soon as I can find my camera. So stay tuned!