Cesarean vs. VBAC: A Dramatic Difference from Alexandra Orchard on Vimeo.
Showing posts with label babies. Show all posts
Showing posts with label babies. Show all posts
Wednesday, July 22, 2009
Cesarean vs, VBAC - a dramatic difference
This is such a touching video and eye opening video. Most people do not realize the force needed to get a baby out during a cesarean section - in the second birth, a vacuum is used as well as manual force. It is 16 minutes long, but worth the time.
The unspoken risk of csections...
Babies scarred as they're born: With thousands of infants injured each year due to Caesarean births, why are mothers not warned of risks?
By Tanith Carey
Last updated at 3:48 PM on 21st July 2009
Matthew Watson is only two years old, but already he has what his mother Wendy calls 'a war wound' - a 31/2in scar which runs from his eyebrow up to his hairline.
It is the legacy of an accident during his Caesarean birth when a surgeon dropped a surgical instrument on his head.
An isolated case? Far from it - Matthew is one of an estimated 3,000 newborns injured during the procedure every year in the UK, and with the Caesarean rate rising, it is likely the number affected will also increase.
Marked for life: Matthew Watson, pictured just after a Caesarean birth, has a scar across his forehead, which his mother Wendy says is not fading
Even if the injury is just a nick, it exposes the newborn to possible infection; in other cases, the wound is also deep enough to scar the child for life.
Like many mothers-to-be, Wendy Watson had no idea that Caesareans carried this risk. Wendy, 32, from Kent, had an emergency C-section after her labour failed to progress.
'Suddenly, during the operation, the surgeon started shouting and swearing at his colleague from the other side of the surgical screen,' says Wendy. 'The surgeon was saying: "Buck your ideas up. Can't you see the position we are in with this patient?''
'It turned out that his assistant, who had been holding the instrument keeping the incision open, had lost his grip and dropped the tool on Matthew's head as he was being delivered.'
But it wasn't until Wendy was handed her baby an hour later that she discovered what had happened.
'Then the surgeon came to apologise for his colleague - he even had a couple of tears in his eyes as he talked to us,' says Wendy, who is married and works as a government finance officer.
'At the time, I'd had such a difficult labour that we were just relieved to have a healthy baby. I was also taken very ill shortly afterwards, with blood clots on my lungs, so it was never discussed any further.'
Newborns: An estimated 3,000 babies are injured during the Caesarean procedure, including cuts that leave deep scars
But far from fading with age as his parents expected, Matthew's scar has stretched as his skull has grown. Wendy says: 'He's too young to notice it and it's currently covered by hair, but he will probably have it for ever now.'
At least the surgeon apologised. In some cases, parents are simply not told about the injuries.
Sarah Fitch was given a Caesarean after her baby was found to be breach at her 40-week check-up.
'It wasn't until I changed Sophia's nappy for the first time that I noticed the cut on her bottom - about 2cm long, and looking fairly deep.
'It was a shock. She was a brand new baby. She was crying all the time, and all I could think was: "You poor little thing. No wonder you're screaming."
'I was really worried because the cut was on her bottom and it could easily have got infected from her nappy,' says Sarah, 32, a financial advisor from Hornchurch, Essex.
'There was no explanation or apology. I had to phone the hospital a week later because the wound had not closed properly and it didn't heal for ten days.'
Dangers: Mothers have complained that they were not warned of the riskis of having a Caesarean birth
For some children, the damage is even more serious. Tyler Robinson, now five, was awarded £10,000 in damages after she suffered a 5.3in cut into the muscle of her thigh and buttocks.
It's not just the babies who suffer - the experience can also prove traumatic for their mothers. Janet Davies was so horrified by the injury to her second child, Lucius, she suffered post-natal stress.
'As soon as he was lifted out of my tummy, I noticed there were several people huddled over him,' says Janet, 39, a project manager from Trafford, Manchester.
'When they eventually brought him over to me, I was shocked to see he had a plaster across his cheek, almost up to his eye.
'Initially I was told it was just a nick from when the doctors had cut through the final layer to get Lucius out. But a week later the plaster came off and I saw a huge cut. I was heartbroken.
'When I finally got through to one of the senior midwives at the hospital, she told me: "You took the risk by wanting to have a C-section."
'Then she reminded me that I had signed a consent form - as if I had signed away all my rights. The main priority seemed to be to fend off lawsuits.
'In the weeks after, I became very depressed. At first, I was diagnosed with post-natal depression. But when I started having flashbacks and nightmares about the birth, I was diagnosed with post-traumatic stress.
'Every time I saw the scar - and it became clear it would never fade - it all came flooding back. For the first year, I hardly ever took pictures of him because I found it so upsetting. In the sunlight it's very clear; it's a real ridge at the top of his cheek.'
The risk of a baby being injured during a Caesarean is about 2 per cent, according to the Royal College of Obstetricians and Gynaecologists. Although many of these injuries are superficial, experts say deeper cuts can also put babies at risk of superbug infections such as MRSA.
The problem usually occurs during emergency Caesareans, explains Pat O'Brien from the Royal College.
Occupational hazard: More experienced surgeons are better at judging the thickness of the womb lining
This is because when a woman has been in labour for a long time, her womb lining becomes very thin - as little as a few millimetres thick. And if her waters have also broken, there is no cushion to protect the baby when the incision is made.
Surgeons often have difficulty telling the wall of the uterus and the baby's skin apart - and heavy bleeding can make it difficult to see what they are cutting.
Sailesh Kumar, a consultant obstetrician and gynaecologist at the country's leading maternity hospital, Queen Charlotte's in London, says cuts to babies are more likely during emergency Caesareans because of the rush to get the baby out.
'Cuts are an occupational hazard,' he says. 'Anyone who has done a lot of C-sections and hasn't seen it happen has been very lucky.'
However, the seniority of the surgeon plays a large part, adds Mr Kumar - more experienced surgeons are better at judging the thickness of the womb lining.
There are also techniques that can be used to reduce the risk, he says. For example, the surgeon can use a finger, rather than a scalpel, to pull apart the final layer of the womb.
Another technique is to gently cut along the womb lining with a pair of scissors - while running a finger under the blade to avoid hurting the baby.
For consultant Pat O'Brien - who performs around 200 Caesareans a year - training is the best way to cut the number of injuries.
'Any cut is one too many. It is important to educate junior doctors so they are cautious during that last incision - and they know to use their fingers rather than a knife. Also, the greater the consultant presence on labour wards, the better.'
Mr O'Brien said the issue of whether mothers should be warned beforehand that babies can be cut was a difficult one.
He said: 'There has to be a balance. Women are warned about many other dangers already. You have to be honest and open, but you don't want to scare women witless.
'But what is absolutely clear is that if a mistake of this sort is made, patients should be told and get an apology.'
• www.babycentre.co.uk
Monday, July 13, 2009
Children 'should sleep with parents until they're five'
This is an older article - but so good.
___________________________________________________________________
May 14, 2006
Sian Griffiths
Margot Sunderland, director of education at the Centre for Child Mental Health in London, says the practice, known as “co-sleeping”, makes children more likely to grow up as calm, healthy adults.
Sunderland, author of 20 books, outlines her advice in The Science of Parenting, to be published later this month.
She is so sure of the findings in the new book, based on 800 scientific studies, that she is calling for health visitors to be issued with fact sheets to educate parents about co-sleeping.
“These studies should be widely disseminated to parents,” said Sunderland. “I am sympathetic to parenting gurus — why should they know the science? Ninety per cent of it is so new they bloody well need to know it now. There is absolutely no study saying it is good to let your child cry.”
She argues that the practice common in Britain of training children to sleep alone from a few weeks old is harmful because any separation from parents increases the flow of stress hormones such as cortisol.
Her findings are based on advances in scientific understanding over the past 20 years of how children’s brains develop, and on studies using scans to analyse how they react in particular circumstances.
For example, a neurological study three years ago showed that a child separated from a parent experienced similar brain activity to one in physical pain.
Sunderland also believes current practice is based on social attitudes that should be abandoned. “There is a taboo in this country about children sleeping with their parents,” she said.
“What I have done in this book is present the science. Studies from around the world show that co-sleeping until the age of five is an investment for the child. They can have separation anxiety up to the age of five and beyond, which can affect them in later life. This is calmed by co-sleeping.”
Symptoms can also be physical. Sunderland quotes one study that found some 70% of women who had not been comforted when they cried as children developed digestive difficulties as adults.
Sunderland’s book puts her at odds with widely read parenting gurus such as Gina Ford, whose advice is followed by thousands.
Ford advocates establishing sleep routines for babies from a very early age in cots “away from the rest of the house” and teaching babies to sleep “without the assistance of adults”.
In her book The Complete Sleep Guide for Contented Babies and Toddlers she writes that parents need time by themselves: “Bed sharing . . . more often than not ends up with parents sleeping in separate rooms” and exhausted mothers, a situation that “puts enormous pressure on the family as a whole”.
Annette Mountford, chief executive of the parenting organisation Family Links, confirmed that the norm for children in Britain was to be encouraged to sleep in cots and beds, often in separate bedrooms, from an early age. “Parents need their space,” she said. “There are definite benefits from encouraging children into their own sleep routine in their own space.”
Sunderland says moving children to their own beds from a few weeks old, even if they cry in the night, has been shown to increase the flow of cortisol.
Studies of children under five have shown that for more than 90%, cortisol rises when they go to nursery. For 75%, it falls whenever they go home.
Professor Jaak Panksepp, a neuroscientist at Washington State University, who has written a foreword to the book, said Sunderland’s arguments were “a coherent story that is consistent with neuroscience. A wise society will take it to heart”.
Sunderland argues that putting children to sleep alone is a peculiarly western phenomenon that may increase the chance of cot death, also known as sudden infant death syndrome (Sids). This may be because the child misses the calming effect on breathing and heart function of lying next to its mother.
“In the UK, 500 children a year die of Sids,” Sunderland writes. “In China, where it [co-sleeping] is taken for granted, Sids is so rare it does not have a name.”
___________________________________________________________________
May 14, 2006
Sian Griffiths
Margot Sunderland, director of education at the Centre for Child Mental Health in London, says the practice, known as “co-sleeping”, makes children more likely to grow up as calm, healthy adults.
Sunderland, author of 20 books, outlines her advice in The Science of Parenting, to be published later this month.
She is so sure of the findings in the new book, based on 800 scientific studies, that she is calling for health visitors to be issued with fact sheets to educate parents about co-sleeping.
“These studies should be widely disseminated to parents,” said Sunderland. “I am sympathetic to parenting gurus — why should they know the science? Ninety per cent of it is so new they bloody well need to know it now. There is absolutely no study saying it is good to let your child cry.”
She argues that the practice common in Britain of training children to sleep alone from a few weeks old is harmful because any separation from parents increases the flow of stress hormones such as cortisol.
Her findings are based on advances in scientific understanding over the past 20 years of how children’s brains develop, and on studies using scans to analyse how they react in particular circumstances.
For example, a neurological study three years ago showed that a child separated from a parent experienced similar brain activity to one in physical pain.
Sunderland also believes current practice is based on social attitudes that should be abandoned. “There is a taboo in this country about children sleeping with their parents,” she said.
“What I have done in this book is present the science. Studies from around the world show that co-sleeping until the age of five is an investment for the child. They can have separation anxiety up to the age of five and beyond, which can affect them in later life. This is calmed by co-sleeping.”
Symptoms can also be physical. Sunderland quotes one study that found some 70% of women who had not been comforted when they cried as children developed digestive difficulties as adults.
Sunderland’s book puts her at odds with widely read parenting gurus such as Gina Ford, whose advice is followed by thousands.
Ford advocates establishing sleep routines for babies from a very early age in cots “away from the rest of the house” and teaching babies to sleep “without the assistance of adults”.
In her book The Complete Sleep Guide for Contented Babies and Toddlers she writes that parents need time by themselves: “Bed sharing . . . more often than not ends up with parents sleeping in separate rooms” and exhausted mothers, a situation that “puts enormous pressure on the family as a whole”.
Annette Mountford, chief executive of the parenting organisation Family Links, confirmed that the norm for children in Britain was to be encouraged to sleep in cots and beds, often in separate bedrooms, from an early age. “Parents need their space,” she said. “There are definite benefits from encouraging children into their own sleep routine in their own space.”
Sunderland says moving children to their own beds from a few weeks old, even if they cry in the night, has been shown to increase the flow of cortisol.
Studies of children under five have shown that for more than 90%, cortisol rises when they go to nursery. For 75%, it falls whenever they go home.
Professor Jaak Panksepp, a neuroscientist at Washington State University, who has written a foreword to the book, said Sunderland’s arguments were “a coherent story that is consistent with neuroscience. A wise society will take it to heart”.
Sunderland argues that putting children to sleep alone is a peculiarly western phenomenon that may increase the chance of cot death, also known as sudden infant death syndrome (Sids). This may be because the child misses the calming effect on breathing and heart function of lying next to its mother.
“In the UK, 500 children a year die of Sids,” Sunderland writes. “In China, where it [co-sleeping] is taken for granted, Sids is so rare it does not have a name.”
Thursday, June 18, 2009
Is the Cord Around the Baby's Neck Really Dangerous?
May 19, 2008 by Misha Safranski
As a confirmed birth junkie, I have heard over and over again birth stories where the baby was born by cesarean for either fetal distress or failure to descend, and the difficulties are blamed on "the cord was around the baby's neck". Is this condition - scientifically termed "nuchal
cord" - actually dangerous? A new study backs up previous research showing that nuchal cord is not the threat it's perceived to be.
A study published this year in the Journal of Perinatal Medicine showed there were no statistically significant differences in outcomes of post-term pregnancies involving a nuchal cord verses no nuchal cord. Drs. Ghosh and Gudmundsson performed color ultrasound on 202 women with post-term pregnancies. Nuchal cords were detected in 69 of the women. There were no significant differences in Apgar scores, umbilical cord anomalies, cesarean section, perinatal death or admission of the baby to the NICU (neonatal intensive care unit).
These findings confirm what has been found in most of the past research on nuchal cord outcomes. A 2006 study from the Archives of Obstetrics and Gynecology was on a much larger scale, looking at the outcomes of 166,318 deliveries during a 15 year study period, 24,392 of which had a documented nuchal cord at birth. The authors, Sheiner et. Al, conclude: "Nuchal cord is not associated with adverse perinatal outcome. Thus, labor induction in such cases is probably unnecessary."
The interesting thing about the Sheiner study is that despite the equivalent outcomes among nuchal cord babies and those without the cord wrapped around the neck, there were higher rates of labor induction and non-reassuring fetal heart tones during labor among the nuchal cord cases.
These two factors are most likely related. We know without a doubt that induction of labor can cause fetal distress. The fact that there were higher induction rates in the nuchal cord group could very well explain the higher rate of transient fetal distress. Induction is nearly always accompanied by AROM (artificial rupture of membranes), which can cause undue pressure on the cord, which can in turn result in blips in the hearttones. Regardless of the cause, the outcomes were still good.
Finally, we look at yet another study which demonstrated that nuchal cord does not result in worse outcomes. In a 2005 study looking at the effects of nuchal cord on birthweight and immediate neonatal outcomes, Mastrobattista, et. Al examined the outcomes of 4426 babies, 775 of whom had a nuchal cord. They found that there were no significant differences between the two groups in birthweight, non-reassuring fetal hearttones, Apgar scores below 7, or operative vaginal deliveries. The cesarean rate was actually highest among the women whose babies did not have a nuchal cord.
The most important thing to keep in mind is that unborn babies do not breathe through their mouth and neck - they receive oxygen through the umbilical cord. This is why it normally doesn't matter if the cord is around the neck (unless the cord is being compressed too much, which is fairly rare). The baby cannot "choke to death" before she/he is born. What we can conclude from the overwhelming majority of data is that nuchal cord - or "cord around the neck" - is not pathological; that is to say, it's not an abnormality. It is a normal condition of the umbilical cord and typically causes no problems with the delivery, even though doctors frequently try to convince parents otherwise.
References:
J Perinat Med. 2008;36(2):142-4. Nuchal cord in post-term pregnancy - relationship to suspected intrapartum fetal distress indicating operative intervention. Ghosh GS, Gudmundsson S. Department of Obstetrics and Gynecology, Malmö University Hospital, Malmö, Sweden.
Arch Gynecol Obstet. 2006 May;274(2):81-3. Epub 2005 Dec 23. Nuchal cord is not associated with adverse perinatal outcome. Sheiner E, Abramowicz JS, Levy A, Silberstein T, Mazor M, Hershkovitz R. Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel. sheiner@bgu.ac.il
As a confirmed birth junkie, I have heard over and over again birth stories where the baby was born by cesarean for either fetal distress or failure to descend, and the difficulties are blamed on "the cord was around the baby's neck". Is this condition - scientifically termed "nuchal
cord" - actually dangerous? A new study backs up previous research showing that nuchal cord is not the threat it's perceived to be.
A study published this year in the Journal of Perinatal Medicine showed there were no statistically significant differences in outcomes of post-term pregnancies involving a nuchal cord verses no nuchal cord. Drs. Ghosh and Gudmundsson performed color ultrasound on 202 women with post-term pregnancies. Nuchal cords were detected in 69 of the women. There were no significant differences in Apgar scores, umbilical cord anomalies, cesarean section, perinatal death or admission of the baby to the NICU (neonatal intensive care unit).
These findings confirm what has been found in most of the past research on nuchal cord outcomes. A 2006 study from the Archives of Obstetrics and Gynecology was on a much larger scale, looking at the outcomes of 166,318 deliveries during a 15 year study period, 24,392 of which had a documented nuchal cord at birth. The authors, Sheiner et. Al, conclude: "Nuchal cord is not associated with adverse perinatal outcome. Thus, labor induction in such cases is probably unnecessary."
The interesting thing about the Sheiner study is that despite the equivalent outcomes among nuchal cord babies and those without the cord wrapped around the neck, there were higher rates of labor induction and non-reassuring fetal heart tones during labor among the nuchal cord cases.
These two factors are most likely related. We know without a doubt that induction of labor can cause fetal distress. The fact that there were higher induction rates in the nuchal cord group could very well explain the higher rate of transient fetal distress. Induction is nearly always accompanied by AROM (artificial rupture of membranes), which can cause undue pressure on the cord, which can in turn result in blips in the hearttones. Regardless of the cause, the outcomes were still good.
Finally, we look at yet another study which demonstrated that nuchal cord does not result in worse outcomes. In a 2005 study looking at the effects of nuchal cord on birthweight and immediate neonatal outcomes, Mastrobattista, et. Al examined the outcomes of 4426 babies, 775 of whom had a nuchal cord. They found that there were no significant differences between the two groups in birthweight, non-reassuring fetal hearttones, Apgar scores below 7, or operative vaginal deliveries. The cesarean rate was actually highest among the women whose babies did not have a nuchal cord.
The most important thing to keep in mind is that unborn babies do not breathe through their mouth and neck - they receive oxygen through the umbilical cord. This is why it normally doesn't matter if the cord is around the neck (unless the cord is being compressed too much, which is fairly rare). The baby cannot "choke to death" before she/he is born. What we can conclude from the overwhelming majority of data is that nuchal cord - or "cord around the neck" - is not pathological; that is to say, it's not an abnormality. It is a normal condition of the umbilical cord and typically causes no problems with the delivery, even though doctors frequently try to convince parents otherwise.
References:
J Perinat Med. 2008;36(2):142-4. Nuchal cord in post-term pregnancy - relationship to suspected intrapartum fetal distress indicating operative intervention. Ghosh GS, Gudmundsson S. Department of Obstetrics and Gynecology, Malmö University Hospital, Malmö, Sweden.
Arch Gynecol Obstet. 2006 May;274(2):81-3. Epub 2005 Dec 23. Nuchal cord is not associated with adverse perinatal outcome. Sheiner E, Abramowicz JS, Levy A, Silberstein T, Mazor M, Hershkovitz R. Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel. sheiner@bgu.ac.il
Monday, April 13, 2009
Saturday, February 21, 2009
What Babies Want Documentary
I hope that I have the opportunity to see this documentary in the near future. It looks amazing. My hope is that our culture comes to understand how important birth and the newborn period is for our babies and how it shapes who they become.
Friday, September 12, 2008
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