Unmedicated Childbirth Advocacy Network Birth Support

Unmedicated Childbirth Advocacy Network
UCAN Birth

Free Support Group in Utah County

"UCAN Birth is a volunteer organization of women interested in advocating for normal, natural, unmedicated childbirth. Think of it as a La Leche League for birth. UCAN Birth headquarters are located in Provo, UT in Utah County and women along the Wasatch front are invited to attend."

How the United States Ranks

There are precious few situations in life where the cheaper alternative is also the better alternative – and maternity care is one. If we eradicated the unjustified obstetric monopoly in the United States, with its extreme medicalization of birth, and replace it with a humanized maternity care, we can vastly improve the care of women and babies, lower death rates for both women and babies, and save vast sums of money at the same time. A few facts:

• Percentage of gross national product spent on health care:
  

1966: 6 percent
1992: 12 percent

• Percentage by which U.S. health care expenditures exceed those of:
  

Canada: 40 percent
Germany: 90 percent
Japan: 100 percent

• The twenty-two countries with lower infant mortality rates than the U.S.: Japan, Sweden, Canada, Singapore, Hong Kong, Netherlands, France, Ireland, Germany, Denmark, Norway, Scotland, Australia, Northern Ireland, Spain, England and Wales, Belgium, Austria, Italy.
• Percentage of countries with lower infant mortality rates than the US that provide universal prenatal care: 100 percent
• Percentage of US women who receive little or no prenatal care: 25 percent
• Chances that a woman with little or no prenatal care will give birth to a low-weight baby(less than 5.5lbs) or premature baby(less than 37wks): 1 in 2
• Factor most closely associated with infant death: low birth weight
• Percentage of infant deaths link to low birth weight: 60 percent
• Average cost of long-term care(through age 35) for a low-birth-weight baby: $50,5588
• Average cost of long-term care (through age 35) for a baby of average birth weight: $20,003
• Cost of newborn intensive care for one infant: $20,00 to $100,00
• Cost of prenatal care for thirty women: $20,000 to $100,000
• Percentage of births attended principally by midwives (CNM’s and CPM’s): United States: 10 percent; European Nations: 75 percent
• Percentage of countries with lower infant mortality rates than the US in which midwives are principal birth attendants: 100 percent
• Average cost of a midwife-attendant birth in the US: $1,200
• Average cost of a physician-attended vaginal birth in the US: $4,200
• Health care cost savings obtainable by using midwifery care for 75 percent of pregnancies in the US: $8.5 BILLION per year
• Cost per year of using routine electronic fetal monitoring during every childbirth: $750 million
• Number of well-constructed scientific studies in which routine electronic fetal monitoring (EFM) during every birth has been proven more effective than the simple stethoscope to monitor the fetal heart: zero
• Health care cost savings obtainable by eliminating the routine use of electronic fetal monitoring in every birth: $675 per year
• US C-section rate: 1965: 5 percent, 2004: 29.1 percent, 2007: 33.3 percent
• Cesarean section rate targeted by the World Health Organization (WHO) and the US Department of Health and Human Services (HHS): 12 percent
• The eighteen industrialized nations and states with lower C-section rates than the US: Czech Republic, Japan, Hungary, Netherlands, England and Wales, New Zealand, Switzerland, Norway, Spain, Sweden, Greece, Portugal, Italy, Denmark, Scotland, Bavaria, Australia, Canada.
• Percentage of women in the US with C-sections who undergo repeat c-sections today: 91 percent
• Ratio of women dying from C-section to women dying from vaginal birth: 4 to 1
• Average cost of a C-section birth: $7,826
• Health care cost savings obtainable by bringing the US C-section rare into compliance with recommendation from WHO and the federal Department of Health and Human Services: $1.5 billion a year
  

Source: Born in the USA by Marsden Wagner,M.D. , 2006

Natural Home Birth of Twins

Natural Home Birth of Twins

I came across a fantastic blog post about a natural home birth of surprise twins. It's a quick read, so please check it out.

I feel that a lot of the feelings this wonderful mother expresses about her birth experience mirror my own feelings about my surprise breech home birth.

Birthing Again: A VBAC Experience

"My first baby was born by cesarean section. My husband and I worked with the same midwives for both births and had desired a natural childbirth with the first. In the first case, I believe that the intervention of surgery was wise. The baby clearly had distress in labor and was born, full term, at only five pounds.

"When my second baby was conceived, we again longed for a natural childbirth. Despite discouragement from doctors and medical advertisements, I was able to birth vaginally this second child. Three conditions especially undergirded this birth: supportive assistants, a pregnancy of heart and body, and an active birth."

Birthing Again: A VBAC Experience is a wonderful article written by Melissa Aberle-Grasse for Mothering Magazine about her VBAC Birth Experience. Please click on the link to read the article in its entirety and learn how Melissa prepared for and followed through with her plans for a Vaginal Birth After Cesarean.

C-Section Not Best For Breech Birth

The Society of Obstetricians and Gynecologists of Canada will launch program to teach physicians breech vaginal delivery

from Globe Life Health and Fitness

by Carla Wintersgill

"Physicians should no longer automatically opt to perform a cesarean section in the case of a breech birth, according to new guidelines by the Society of Obstetricians and Gynecologists of Canada.

"Released yesterday, the guidelines are a response to new evidence that shows many women are safely able to vaginally deliver babies who enter the birth canal with the buttocks or feet first. Normally, the infant descends head first.

“Our primary purpose is to offer choice to women,” said André Lalonde, executive vice-president of the SOGC.

“More women are feeling disappointed when there is no one who is trained to assist in breech vaginal delivery,” he adds.

"Since 2000, C-sections have been the preferred method of delivery in breech births. Studies suggested that breached births were associated with an increased rate of complication when performed vaginally.

"As a result, many medical schools have stopped training their physicians in breech vaginal delivery.

"The problem now, according to Dr. Lalonde, is that there is a serious shortage of doctors to teach and perform these deliveries.

"With the release of the new guidelines, the SOGC will launch a nationwide training program to ensure that doctors will be adequately prepared to offer vaginal breech births .

"The new approach was prompted by a reassessment of earlier trials. It now appears that there is no difference in complication rates between vaginal and cesarean section deliveries in the case of breech births.

"News of the change is a boon for the Ottawa-based Coalition for Breech Birth.

“We're really, really pleased,” said Robin Guy, co-founder of the coalition.

"Ms. Guy started the group after the birth of her second child in the fall of 2006. Although she had given birth to her first child at home with a midwife, Ms. Guy delivered her daughter in the hospital because of the baby's breech position.

“I was cornered into an unneeded and unwanted C-section because the obstetrician that I had didn't have the experience to catch her,” said Ms. Guy.

"The aim of the coalition is to ensure that women know what their options are when it comes to breech birth. Ms. Guy believes that many women don't realize that vaginal breech births are even possible.

“Educating women is our primary goal because it takes more than just a guideline change,” she said.

"The SOGC stresses that because of complications that may arise, many breech deliveries will still require a cesarean section.

"Breech presentations occur in 3-4 per cent of pregnant women who reach term. That translates to approximately 11,000 to 14,500 breech deliveries a year in Canada.

"The new decision to offer vaginal breech birth aligns with the SOGC promotion of normal childbirth – spontaneous labour, followed by a delivery that is not assisted by forceps, vacuum or cesarean section. In December of 2008, the society release a policy statement that included its recommendation for a development of national practice guidelines on normal childbirth.

“The safest way to deliver has always been the natural way,” said Dr. Lalonde.

“Vaginal birth is the preferred method of having a baby because a C-section in itself has complications.”

"Cesarean sections, in which incisions are made through a mother's abdomen and uterus to deliver the baby, can lead to increased chance of bleeding and infections and can cause further complications for pregnancies later on.

“There's the idea out there in the public sometimes that having a C-section today with modern anesthesia and modern hospitals is as safe as having a normal childbirth, but we don't think so,” said Dr. Lalonde.

“It is the general principle in medicine to not make having a cesarean section trivial.”

"The SOGC believes that if a woman is well-prepared during pregnancy, she has the innate ability to deliver vaginally.

"The national average for babies delivered via cesarean section in Canada is 25 per cent."

Liam rocks the house! - A Father's Perspective on Birth

My husband wrote this just two days after the birth of our little boy. I was pretty busy at the time and didn't think to post it. So here it is, better late than never!

Liam rocks the house! We are thrilled to announce that Liam was born at home! My wife has wanted to do a home birth for a long time, and after a lot of research, studying, and prayer about it we finally had the opportunity to work with an amazing Midwife and her attendants/ apprentices who were all either Doula's (Labor Support for Mommy) and/or Midwife's. We'd done natural births on the last two kids in the hospital with a Doula and this just seemed like a progression for my wife. I've always supported her decisions and I must admit that I was the one that dared her into doing an all natural birth in the first place. :)

For me the whole labor process the night/morning of his arrival was so laid back compared to anything we'd ever experienced in the hospital deliveries we'd had, there was a sense of complete peace and comfort, which I think comes from the fact we were able to have complete control over ambiance and atmosphere that you can never truly attain in a hospital environment. Hospitals are wonderful, but ultimately you are playing by their rules, understandably, not your own. You don't always get the one-on-one attention and support from the Doctor and Nurse staff, again understandable, and my wife always misses having the kids and me there during her recovery time, which we have been able to do this go around. Call her crazy, but she actually missed them and their monkey mayhem, and so did I.

My wife spent most of the night/morning in the birthing tub (she LOVES a nice hot bath!) and I was there to give support by either holding acupressure points that give pain relief or giving direct pressure on her sacrum or hips to ease the back labor, with the Midwife and her attendant there to aid when needed. There was a spirit of peace and calm that just permeated the house, and at one point I remember the Midwife commenting "I'll deliver your babies anytime, this is so much easier than most other births." She and her attendant, at least early on, spent the time making preparations for when they were needed, including being super and nice and washing some dishes and cleaning the table and countertop off, things I totally did not expect but greatly appreciated.

Liam was born in a birthing tub...breach! Let me tell you it was an incredible experience to witness as the Midwife and her attendants aided my wife and coached her on what to do. He came out butt first, then one leg, then the other leg, and then once his torso was free and he started getting his arms out he actually started helping pull and push himself out, including lifting his head free at the end. :D My two oldest kids were able to be there at the very end to witness it, and I gave Max the honors of cutting the cord when the time came. It is a life experience that I wish I could actually put into the proper words, I feel like even words can't truly describe the whole experience. Each birth of my children has been beautiful in its own way, each experience so unique, such miracles.

Now to what everyone really wants to know, his stats. He weighed in at a nice 7 lbs 15 oz and was 21 inches long. He has a head full of dark hair, and the few times he has graced us with a peek at his gorgeous eyes we think that they might be hazel, like Dad (Yay!), as we caught flecks of green and blue, so we'll just have to wait and see. He is an absolutely perfect little boy, not that I'm biased of course. :) Momma and the baby are both doing great, we're all just playing the sleep deprivation catch-up game...which any Parent will admit we never truly regain, I can sleep more when I'm dead. :P

If you're interested in reading my (the mother's) perspective of the birth, check out The Home Water Birth Breech Delivery of Liam.

Latest Study on Home Birth From the Canadian Medical Association Journal

The September 15th issue of Canadian Medical Association Journal has a new study on the safety of home birth in comparison to hospital birth.

"The Society of Obstetricians and Gynaecologists of Canada encourages research into the safety of all birth settings. It does not take a specific stand on home birth. In 2008, the American College of Obstetricians and Gynecologists reiterated its longstanding opposition to home births, stating that the choice to deliver at home places the process of giving birth ahead of the goal of having a healthy baby. In contrast, the Royal College of Obstetricians and Gynaecologists in the United Kingdom has issued a statement supporting home birth as a viable choice for women with uncomplicated pregnancies.

"In this study, we ascertained outcomes of all planned home births attended by registered midwives in an entire health region with a single-payer universal health care system. We compared them with the outcomes of all planned hospital births that met the criteria for home birth and were attended by the same cohort of midwives. We also compared the outcomes of a matched sample of women of similar risk status who planned to deliver in hospital with a physician in attendance.

"Our study showed that planned home birth attended by a registered midwife was associated with very low and comparable rates of perinatal death and reduced rates of obstetric interventions and adverse maternal outcomes compared with planned hospital birth attended by a midwife or physician. Our population rate of less than 1 perinatal death per 1000 births may serve as a benchmark to other jurisdictions as they evaluate their home-birth programs."

Click here for the full article:

Outcomes of Planned Home Birth Versus Hospital Birth

Background Information About ACOG's Anti-Midwife Smear Campaign

Ever since the release of the documentary film The Business of Being Born by Ricki Lake and Abby Epstein, there has been a nationwide increased interest in un-medicated birth and home birth. Along with this surge of interest, there has also been some serious backlash from the American College of Obstetrics and Gynecologists. In the article below, you can read some background of this anti-midwife smear campaign:

“The Perils of Journalism:” Ricki and Abby’s Response to the Today Show

For more information, please see my earlier post:
Physicians Take Anti-Midwife Smear Campaign to the Airwaves

Physicians Take Anti-Midwife Smear Campaign to the Airwaves

PushNews from The Big Push for Midwives Campaign
CONTACT: Katherine Prown, (414) 550-8025, katie@thebigpushformidwives.org
FOR IMMEDIATE RELEASE: Friday, September 11, 2009

Physicians Take Anti-Midwife Smear Campaign to the Airwaves
Home Birth Mothers, Celebrities, Insulted on National TV

WASHINGTON, D.C. (September 11, 2009)—Referring to women who choose to give birth in out-of-hospital settings as “hedonistic” and likening childbirth to a “spa treatment,” members of the American College of Obstetricians and Gynecologists, a trade group representing the professional and financial interests of OB/GYNs, took their anti-midwife campaign to the airwaves in a Today Show segment rife with insults, stereotypes, and misinformation, using one family’s tragedy as a platform for the organization’s well-funded assault against choices in childbirth.

“About the only thing ACOG has right is that women are choosing out-of-hospital deliveries in record numbers,” said Steff Hedenkamp of The Big Push for Midwives Campaign. “What Erin Tracy and other apologists for the group’s anti-midwife position fail to see is that one of the forces driving women to seek out-of-hospital care is the paternalistic, profit-driven model of maternity care that far too many of its own members provide.”

During the segment ACOG reiterated its claim, which has been thoroughly debunked by a large and growing body of medical literature, that out-of-hospital delivery is unsafe. Describing women who choose to give birth in private homes and freestanding birth centers as “hedonistic” mothers who knowingly put the lives of their babies at risk for the sake of an “experience” they believe will be like a “spa treatment,” members of the group echoed last year’s position statement claiming that women who choose out-of-hospital deliveries base their decisions on what’s “fashionable” or “trendy.”

“ACOG clings to this ridiculous fantasy that women choose to deliver their babies outside of the hospital because they want to be like Ricki Lake, Demi Moore or Meryl Streep and that if women would only watch enough fearmongering stories on morning television they’ll be brainwashed back into hospitals,” said Katherine Prown, Campaign Manager of The Big Push for Midwives. “Insulting our intelligence and promoting policies that deny us choices in maternity care are not exactly winning strategies for stemming the tide of women seeking alternatives to standard OB care.”

Earlier this year, a New York City couple lost their baby during a planned home birth under the care of a Certified Nurse-Midwife. Licensed and regulated in all 50 states, Certified Nurse-Midwives are trained to provide hospital-based maternity care. By contrast, Certified Professional Midwives, who undergo specialized clinical training in out-of-hospital birth, are legally authorized to provide care in 26 states, although outdated regulations effectively prevent them qualifying for licensure in the state of New York.

Legislation to license and regulate Certified Professional Midwives is currently pending in an additional 18 states, despite staunch opposition from the American Medical Association, which has joined with ACOG in adopting position statements that would deny families who choose out-of-hospital maternity care legal access to nationally credentialed midwives with specialized training to provide it.

The Big Push for Midwives Campaign represents thousands of grassroots advocates in the United States who support expanding access to Certified Professional Midwives and out-of-hospital maternity care. The mission of The Big Push includes educating national policymakers about the reduced costs and improved outcomes associated with out-of-hospital birth and advocating for including the services of Certified Professional Midwives in health care reform. Media inquiries: Katherine Prown (414) 550-8025, katie@thebigpushformidwives.org

I copied this from The Big Push for Midwives

Reducing Infant Mortality

Newborn Mortality (Death) Rate

The United States is one of the only developed nations that continues to have worse infant mortality rates every year. We see more newborn death in the U.S. than every other country in the world that has adopted mother-friendly and baby-friendly birth and post-natal practices.

The video below is very good. It explores the causes of and solutions for infant death. Please take the time to watch it.

Reducing Infant Mortality from Debby Takikawa on Vimeo.

How to Get Baby in the Best Position for Childbirth - No Back Labor!

This is an excellent video that shows the positions you can use to encourage your baby to move into a favorable position for birth. This is especially helpful if the baby is in a posterior position:

For more information about posterior babies, please read my previous post:
When Baby is in a Posterior Position

Click on the following link to access the same video on Youtube:
How to Get Baby in the Best Position for Childbirth - No Back Labor!

The Evidence Says: Epidurals Do Impact Newborns

"There are many controversies in maternity care. The spectrum of debates run to both ends of the spectrum: from those who feel all women should have interventionized maternity care to the home birth advocates. However, one of the most controversial topics in care is epidural anesthesia.

"Fueling the flame of the epidural controversy are the diametrically opposite positions published in anesthesia journals vs. those in other medical journals such as nursing, midwifery and family practice.

"In most hospitals, laboring women who have received epidural anesthesia are confined to bed as they no longer can rely on their legs for stability. This may severely limit movement and positioning. Additionally, hospitals may have a policy that all laboring women receiving medication, specifically epidural anesthesia, have an internal fetal heart monitor in place. This requires breaking of the amniotic sac or membranes in a procedure known as amniotomy. Occasionally, it may be necessary to augment or stimulate a labor with Pitocin after an epidural has been given, as epidurals have been shown to slow some women's labors – making the labor longer and harder on the woman’s body (Mayberry, L.J., Clemmens, D., De, A. Epidural analgesia side effects, co-interventions, and care of women during childbirth: a systematic review. American Journal of Obstetrics & Gynecology. 2002 May;186(5 Suppl Nature):S81-93.

"Researchers have linked epidural anesthesia to assisted delivery, or the use of forceps or vacuum extraction during the pushing portion of labor (Torvaldsen, S., Roberts, C.L., Bell, J.C., Raynes-Greenow, C.H. Discontinuation of epidural analgesia late in labour for reducing the adverse delivery outcomes associated with epidural analgesia. Cochrane Database Systematic Review. 2004 Oct 18;(4):CD004457.). Researchers also find that 88% of women who requested an epidural for pain in one study reported being less satisfied with their childbirth experience than those who did not, despite lower pain intensity. Pre-labor survey results suggest that concerns about epidurals and their effect on the baby, greater than anticipated labor pain, perceived failure of requesting an epidural, and longer duration of labor may have accounted for these findings.( Kannan, S., Jamison, R.N., Datta, S. Maternal satisfaction and pain control in women electing natural childbirth. Regional Anesthesia and Pain Medicine. 2001 Sep-Oct;26(5):468-72.

"Epidural anesthesia also causes a drop in maternal blood pressure, thus the need for 1000 ml of IV fluids administered prior/during the administration of the anesthesia.

"For the newborn, the effects of epidural anesthesia are more hazardous. Women who have epidurals are less likely to fully breastfeed in the first few days and are more likely to stop breastfeeding in the first 24 weeks due to the difficulty newborns have in coordinating sucking and latching. (Torvaldsen, et al. Intrapartum epidural analgesia and breastfeeding: a prospective cohort study. International Breastfeeding Journal 2006 Dec 11; 1:24. Oxytocin and prolactin stimulate milk ejection and milk production during breastfeeding. When used in combination during the labor process, which happens frequently, epidural anesthesia and pitocin influenced endogenous oxytocin levels negatively ~ thus negatively impacting both milk ejection and milk production. Jonas et al. Effects of intrapartum oxytocin administration and epidural analgesia on the concentration of plasma oxytocin and prolactin in response to suckling during the second day postpartum. Breastfeeding Medicine 2009 June; 4(2): 71-82.

"Countless other studies including the Journal of the American Board of Family Medicine and Dr. Sarah Buckley all focus on the hazardous impact of epidurals on breastfeeding and the newborn.

"This evidence may be an inconvenient truth."

I found this article at: The Evidence Says: Epidurals Do Impact Newborns

In a personal note: Each time I had an epidural, it seemed to delay my breast milk production. I had an epidural with the birth of each of my first two babies, and the only impact I noticed is that my milk took an extra day to come in. With both of them there was a very hard day when the baby was screaming in hunger and all I had was colostrum to feed them and they weren't satisfied until my milk came in the next day. With my 3 un-medicated births my milk came in exactly when the baby's appetite increased enough to need it.

A Holistic Approach to Childbirth - on Oprah.com and Oprah Radio

Oprah Radio host Dr. Mehmet Oz talks with nurse midwife Pam England about preparing for childbirth.

"For many women, the birthing process can be a profound, natural rite of passage rather than a painful medical event, says Pam England, a mother of two and certified nurse midwife. Dr. Oz talks with Pam, who answers some of the most common questions about the birthing process. Plus, Pam shares her recommendations for both moms- and dads-to-be for having the best birthing experience possible.

"Who should deliver at home?
Many women can have a safe, healthy delivery at home, Pam says. Women should take a holistic approach in determining whether a home birth is right for them. In addition to a physical screening, Pam says women should assess their emotional mind-set and whether they have the support of close loved ones.

"What's the best position for birthing?
Lying on the back is convenient for physicians, but "it's the worst thing for a woman," Pam says. This position, while common, is more painful for the woman because it collapses the diameter of the pelvis up to an inch, making delivery more difficult. Instead, Pam recommends women stand upright, move around and squat—keeping their hips higher than their knees—until they find the positions that best suit them.

"Are epidurals necessary?
While eliminating pain has become a social norm, Pam says it may not be in the best interest of the woman. When an epidural is given, Pam says it interrupts the biofeedback mechanism in the body in which the dilating cervix sends messages to the brain to produce more oxytocin, which in turn leads to the release of endorphins, which are natural pain killers. Labor often slows down or stops as a result, which requires additional drugs be administered, Pam says. While it's up to a woman to decide whether she wants an epidural, Pam says it's important that women do not feel shame for feeling pain or expressing that pain during childbirth.

"What should a father's role be during childbirth?
Fathers can be traumatized by witnessing the birth of their child and not knowing what to do, Pam says. Therefore, she says fathers who've been through the experience should help new fathers prepare mentally and emotionally. "From the fathers' points of view, they can get real advice about what is it like to experience birth as a father and what helps fathers experience birth in a way that's constructive for them," Pam says."

Click here to listen to the radio broadcast on Oprah Radio

or

Click here for the article on Oprah.com