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.

Her Survival Was a “Christmas Miracle,” but the Disaster Was Man-Made

Her Survival Was a “Christmas Miracle,” but the Disaster Was Man-Made

Problems and Hazards of Induction of Labor

Check out this great article on the problems and hazards of induction of labor.

5 Reasons to Avoid Induction

The Risk of Inducing Labor

By Robin Elise Weiss, LCCE, About.com

The induction of labor can be done for many reasons, including many valid medical reasons. However, the rise in the rate of social inductions, or elective inductions is on the rise. As the induction rate rises there are more babies and mothers placed at risk for certain complications. Here are five risks of induction that you may not know about:

1. Increased risk of abnormal fetal heart rate, shoulder dystocia and other problems with the baby in labor.
Labor induction is done by intervening in the body's natural process, typically with powerful drugs to bring on contractions or devices that are used to break the water before labor starts. Both of these types of induction can cause the baby to react in a manner that is called fetal distress as seen by fetal monitoring.

The nature of induction like contractions may also be more forceful than natural labor. This can cause your baby to assume or stay in an unfavorable position for labor making labor longer and more painful for the mother. It can also increase the need for other interventions as well.

2. Increased risk of your baby being admitted to the neonatal intensive care unit (NICU).
Babies who are born via induction have not yet sent signals to the mother to start labor. This means that they simply aren't yet ready to be born. This risk is worth it if the baby or mother's lives are in danger, but simply to take this risk for elective reasons may not be well advised.

When a baby is in the intensive care unit there is less ability for you to be with your baby or to hold your baby. Breastfeeding usually gets off to a rocky start as well. This can usually be avoided by giving birth when your body and baby say it is time.

3. Increased risk of forceps or vacuum extraction used for birth.
When labor is induced babies tend to stay in unfavorable positions, the use of epidural anesthesia is increased and therefore the need to assist the baby's birth via the use of forceps and vacuum extraction is also increased.

4. Increased risk of cesarean section.
Sometimes labor inductions don't take, but it's too late to send you home, the baby must be born. The most common cause of this is that the bags of waters has been broken, either naturally or via an amniotomy. Since the risk of infection is greater, your baby will need to be born via c-section.

A cesarean in an induced labor is also more likely for reasons of malpresentation (posterior, etc.) as well as fetal distress.

5. Increased risks to the baby of prematurity and jaundice.
Induction can be done before your baby is ready to be born, because your due date is off or because your baby simply needed more time in the womb to grow and mature their lungs. Your baby may also be more likely to suffer from jaundice at or near birth because of the induction. This can lead to other medical treatments as well as stays in the hospital for your baby.

Being born even a week or two early can result in your baby being a near term or late preterm infant. This means that your baby is likely to have more trouble breathing, eating and maintaining temperature.

Reducing Infant Mortality

This is an awesome video on reducing infant mortality here in the states. Take the time and watch it - it is under 17 minutes long.

Reducing Infant Mortality from Debby Takikawa on Vimeo.

Caution urged on inducing labor

By TODD ACKERMAN

July 21, 2009, 12:18AM

Doctors are being advised not to induce labor for non-medical reasons prior to 39 weeks into a pregnancy under revised guidelines released today by the nation's association of obstetricians and gynecologists.

The guidelines, the first since 1999, arrive amid concern about the increase in the number of such procedures in the last two decades. The rate of induced labor has increased from 90 per 1,000 births in 1990 to 225 per 1,000 births in 2006.

“It's really become an epidemic,” said Dr. Mildred Ramirez, an author of the American College of Obstetricians and Gynecologists guidelines and professor of ob-gyn at the University of Texas Medical School at Houston. “The doctor and patient need to weigh the risks and benefits — there will be exceptions — but I hope the consequence of the guidelines is a reduction in the rate.”

But another Houston ob-gyn called the guidelines “pretty lax” and said she doubted they would have a significant effect.

Ramirez characterized the rate as “alarmingly high” in many hospitals and said there are ones in Houston where labor is induced 50 percent of the time.

While induction is relatively safe, it's been associated with increased risk of Caesarean sections. Studies have found it also leads to longer hospital stays and higher costs.

There are many occasions when there are clear-cut medical reasons for inducing, such as when health problems complicate a pregnancy and when pregnancies are more than two weeks past the due date. The health problems include diabetes or high blood pressure in the pregnant woman, premature rupture of membranes that encase the unborn baby and fetal issues such as an irregular heartbeat.

The new guidelines focus mostly on setting forth when and how to induce labor in such situations. Ramirez said there is significant new data since 1999 comparing the different regimens and their side effects.

Guidelines not set in stone

The guidelines are non-binding, but could be interpreted to make a doctor more liable if he or she doesn't follow them and something goes wrong.

Over the past 20 years, the decision to induce has increasingly involved not health concerns but convenience — for the mother, family or doctor. Patients often request induction because they're tired of the pregnancy, want to make sure their doctor is there instead of a different doctor who might have to deliver if labor occurs at night or prefer to time the delivery to most efficiently manage their allotted time off from work.

The guidelines take no position on such so-called “soft” reasons for inducing labor.

But for the first time, they stress that mature fetal lung test results before 39 weeks of gestation by themselves aren't enough to justify inducing. Such results — fetal lungs are mature at 37 weeks 90 percent of the time — sometimes have been used as a criterion to induce early.

They also call for a physician capable of performing a Caesarean to be available if induction doesn't produce a successful vaginal delivery.

The increased rate has led some hospitals around the nation in recent years to implement their own stricter guidelines on elective use of the procedure. But Dr. Damla Dryden, an ob-gyn with the Women's Specialists of Houston at Texas Children's Hospital, said the demand is so great it will take a stronger statement than the new guidelines to get more hospitals on board.

“People keep pushing to induce earlier and earlier,” said Dryden. “The new guidelines stress the issue a little more clearly than previously, but journal articles and studies have pointed out the trend for a while now and doctors still feel a lot of pressure from patients for it.”

Dryden called the trend the same one that's caused Caesarean sections to increase recently, “the idea that some patients want to get the baby out before something goes wrong.”

Ramirez said the authors didn't delve more into the overuse of labor induction because they saw the guidelines' purpose as educating physicians about the current state of knowledge given the procedure's frequency, but acknowledged it's “a valid point” that they could have used the occasion to come out more forcefully against the trend.

Ramirez said the authors didn't delve more into the overuse of labor induction because they saw the guidelines' purpose as educating physicians about the current state of knowledge given the procedure's frequency, but acknowledged it's “a valid point” that they could have used the occasion to come out more forcefully against the trend.

There is no one accepted number for the rate of inductions done for nonmedical reasons, but studies have put it from 15 percent to 55 percent of the total number.

todd.ackerman@chron.com

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

Read more: http://www.dailymail.co.uk/health/article-1201049/With-thousands-infants-injured-year-Caesarean-births-mothers-warned-risks.html?ITO=1490#ixzz0M1xM5tO7

C-section Births Cause Genetic Changes That Could Increase Odds For Developing Diseases In Later Life

Swedish researchers have discovered that babies born by Caesarean section experience changes to the DNA pool in their white blood cells, which could be connected to altered stress levels during this method of delivery, according to the July issue of Acta Paediatrica.

It is thought that these genetic changes, which differ from normal vaginal deliveries, could explain why people delivered by C-section are more susceptible to immunological diseases such as diabetes and asthma in later life, when those genetic changes combine with environmental triggers.

Blood was sampled from the umbilical cords of 37 newborn infants just after delivery and then three to five days after the birth. It was analysed to see the degree of DNA-methylation in the white blood cells - a vital part of the immune system.

This showed that the 16 babies born by C-section exhibited higher DNA-methylation rates immediately after delivery than the 21 born by vaginal delivery. Three to five days after birth, DNA-methylation levels had dropped in infants delivered by C-section so that there were no longer significant differences between the two groups.

“Delivery by C-section has been associated with increased allergy, diabetes and leukaemia risks” says Professor Mikael Norman, who specialises in paediatrics at the Karolinska Institutet in Stockholm, Sweden. “Although the underlying cause is unknown, our theory is that altered birth conditions could cause a genetic imprint in the immune cells that could play a role later in life.

“That is why we were keen to look at DNA-methylation, which is an important biological mechanism in which the DNA is chemically modified to activate or shut down genes in response to changes in the external environment

. As the diseases that tend to be more common in people delivered by C-section are connected with the immune system, we decided to focus our research on early DNA changes to the white blood cells.”

The authors point out that the reason why DNA-methylation is higher after C-section deliveries is still unclear and further research is needed.

“Animal studies have shown that negative stress around birth affects methylation of the genes and therefore it is reasonable to believe that the differences in DNA-methylation that we found in human infants are linked to differences in birth stress.

“We know that the stress of being born is fundamentally different after planned C-section compared to normal vaginal delivery. When babies are delivered by C-section, they are unprepared for the birth and can become more stressed after delivery than before. This is different to a normal vaginal delivery, where the stress gradually builds up before the actual birth, helping the baby to start breathing and quickly adapt to the new environment outside the womb.”

The authors point out that the surgical procedure itself may play a role in DNA-methylation and that factors other than the delivery method need to be explored in more detail.

“In our study, neonatal DNA-methylation did not correlate to the age of the mother, length of labour, birth weight and neonatal CPR levels - proteins that provide a key marker for inflammation” says Professor Norman. “However, although there was no relation between DNA-methylation and these factors, larger studies are needed to clarify these issues.”

Professor Norman states that the Karolinska study clearly shows that gene-environment interaction through DNA-methylation is more dynamic around birth than previously known.

“The full significance of higher DNA-methylation levels after C-section is not yet understood, but it may have important clinical implications” he says.

“C-section delivery is rapidly increasing worldwide and is currently the most common surgical procedure among women of child-bearing age. Until recently, the long-term consequences of this mode of delivery had not been studied. However, reports that link C-section deliveries with increased risk for different diseases in later life are now emerging. Our results provide the first pieces of evidence that early ‘epigenetic’ programming of the immune system may have a role to play.”

The authors feel that their discovery could make a significant contribution to the ongoing debate about the health issues around C-section deliveries.

“Although we do not know yet how specific gene expression is affected after C-section deliveries, or to what extent these genetic differences related to the mode of delivery are long-lasting, we believe that our findings open up a new area of important clinical research” concludes lead author Titus Schlinzig, a research fellow at the Karolinska Institutet.

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.

Quote from Midwifery Today Newsletter

I just received this in my email earlier this morning. I couldn't agree with it more.
_______________________________________
My experience has been that if labour is allowed to progress normally, outcomes for mother and babies are better. This does not mean that existing complications of pregnancy or potential problems in pregnancy are not assessed and dealt with expeditiously.
I feel that all too often the introduction of prostins and oxytoxic preparations, stretching of the cervix and early rupture of the membranes are deployed for varying reasons.
Manual manipulation of the cervix to force it to full dilation often ends with cervical incompetence, cervical tears, arrested labour and retained placenta.
My theory relative to retention of the placenta is that because all the normal processes have occurred prematurely, the readiness of the placenta to be detached is delayed. I refer to this as placental embarassment, commonly called retained placentas.
— Movena Bowe-ClarkeNassau, BahamasExcerpted from "Cards and Letters," Midwifery Today, Issue 74