Saturday, July 31, 2010

Cesarean vs. VBAC Video

One mother's journey through 2 c-sections and a Home Birth After 2 Cesareans (HBA2C)

What are some of the differences you notice?

Cesarean vs. VBAC:  A Dramatic Difference from Alexandra Orchard on Vimeo.

Friday, July 30, 2010

Vaginal Exams: Useful Tool or Unnecessary Intervention?

Vaginal exams are something that women have come to accept as an uncomfortable part of being pregnant and having a baby. Before the onset of labor, a care provider may put their gloved fingers into the vagina of the expectant mother to check her cervix and see if it has opened up, and how much. During labor vaginal exams are routinely used to determine how much progress a woman has made in labor.

Effacement is the thinning of the cervix, and is expressed generally as a percentage. 80% percent effaced, for example, indicates that the cervix has thinned out 80% and still has another 20% to thin out completely. Effacement can precede or accompany dilation.

Dilation or dilatation (depending on your preference of terminology) is the opening of the cervix. Generally 1 fingertip-breadth (of the provider who is checking you) equates to 1 cm of dilation, 2 fingertips equals 2 cm, and so on, all the way up to 10 centimeters (or "complete"). The provider actually sticks their fingertips into the cervical opening to check this measurement.

Many times the vaginal exam is used to guess how much longer a woman may have left before the baby will be born. Unfortunately, this is a poor indication because every woman dilates and progresses at her own pace. There are many factors that affect labor progress, and it's unrealistic to rely on cervical checks to predict the future. I believe vaginal exams are a small part of our modern world's effort to control labor, combined with the use of medications to start and speed up labor to try and fit it into our schedules and what we think labor should look like.

Vaginal exams are uncomfortable in the least, and sometimes downright painful. At times during labor the provider may want to do a vaginal exam at the height of a contraction, which makes it even more uncomfortable. From my experience, it can also interfere with the laboring woman's focus and coping techniques and make it harder for her to work through the contraction.

Vaginal exams can be harmful. Yes, you read that right. Downright dangerous. When anything is inserted into the vagina (gloved or not) it brings bacteria from the outside of the body into the birth canal. Our bodies have different types of bacteria in different places, and they're not meant to be mixed up and put in places where they aren't normally found. This can cause maternal infection and fever, particularly if the bag of waters has already ruptured.

If your has water broken (before or during labor) and you want to avoid the risk of infection, AVOID VAGINAL EXAMS.

The reason hospitals have time limits on labor (baby must be born within 12, 24, or X number of hours after rupture of membranes) is because of this risk of infection. If you avoid vaginal exams (or anything that could contaminate the birth canal) you may virtually eliminate this risk, and you can safely wait for labor to start and progress on its own.

I've covered the risk. Now let's talk about the alternatives.

How Dilated Am I? Assessing Dilation in Labor WITHOUT an Internal Exam.: This is a really good blog post outlining multiple ways of checking labor progress without an intrusive vaginal exam. These methods include closely observing outward signs from the mother including the sound of her voice, smells, irrational thinking, feeling the top of the uterus, and more. I've found it to be extremely helpful.

Checking dilation without a vaginal exam: I love this post, as it outlines very specifically how to use touch to measure the space between the top of the fundus (uterus) to the breastbone:

"During a contraction and with mom on her back, determine how many fingerbreadths of space are between the fundus [top of the uterus] and xiphoid process [the triangular tip of the breastbone] at the height of a contraction.

5 fb = no dilation
4 fb = 2 cm
3 fb = 4 cm
2 fb = 6 cm
1 fb = 8 cm
0 fb = complete"

My understanding is that it's best to use the fingerbreadths of the mother herself, but someone else can check the measurement as well.

Isn't that great?! These posts give great information that can help empower women to stay comfortable and safe in labor, and also arm them with tools to help them in the process.

Here is another article outlining The Dangers of Vaginal Exams if you want to learn more.

Wednesday, July 28, 2010

The Raw Truth About Power and Control

Who controls birth?

I came across an article on MSNBC by Taffy Brodessor-Akner called Who controls childbirth - expectant moms or doctors?

In her article, Ms. Brodessor-Akner talks about the extremely traumatic birth of her first child and the impending birth of her second child. She opens up with her raw feelings, and it's powerful. She talks about her journey, of trying to heal and move forward, of facing the future with the hope of something better.

The author also talks about home birth but admits that she's not comfortable birthing anywhere but in the hospital.  The feelings and questions that she brings up in her article are so poignant, and I think they bear careful consideration. This article reminds me of how each and every birth is individual and sacred, and should be handled with appropriate care. Each mother and father should make the choices they feel are best for that birth, regardless of what happened at previous births or what so-and-so says and what everyone else thinks they should do. It's a personal decision, each and every step of the way.

In response to the article, Sheridan at Enjoy Birth asks the same question: Who DOES Control Childbirth? She argues that it depends on who the mother chooses as her care provider. She also provides a library of information to help women make the best choice in care provider for their child's birth, and lots of reasons why they should be judicious in their choice.

She has a point. Afterall, the woman's choice in her care giver determines how much power and decision-making she will give up. Giving power to someone isn't bad, if that person truly has your best interests at heart and understands and supports them.

In my personal experiences with birth, it has all been about control. Whether I have a positive or negative experience depends largely on how much I feel control was either respected or taken from me. I feel this was dependent on how much control I gave to others, and in whom I chose to trust with that power.

In this respect, I think Sheridan is absolutely right, and I also feel a woman's realm of control in birth extends further than her choice in a provider. She also has the power to choose her support team, the location and circumstances under which she wants to labor and give birth.

Can you really determine the circumstances of your baby's birth? In her MSNBC article, Ms. Brodessor-Akner talks about how unpredictable childbirth is, and how birth plans are a waste of time because of this. Yes, birth is unpredictable, but women still have power in the interventions they choose to accept or avoid. They can choose under what circumstances they want to labor and birth by choosing whether to allow a medical induction or augmentation, or to wait for spontaneous labor to start on its own. They can choose whether to birth in a place where certain things are required as "protocol", such as electronic fetal monitoring, breaking of waters, IV placement, and more. They can decide which interventions to accept or decline, and their decision in care provider and location will have a large impact on these other aspects.

I believe as we attempt to exert control in pregnancy and birth, we must also come to terms with a certain lack of control. This is where faith comes in. I do everything possible to educate myself to make the best decisions, and as I move forward knowing I've extended the limit of my personal power, I trust in something bigger, more powerful to guide me through. For some people this is a trust in nature, in our bodies to perform as they were made to.

For me, it's faith in God.

As I see it, God created the world and everything in it. He is nature. He created me, and He knows what I'm capable of. God has control in things I don't, and He has my best interests in mind.

"The next moment is as much beyond our grasp, and as much in God's care, as that a hundred years away. Care for the next minute is as foolish as care for a day in the next thousand years. In neither can we do anything, in both God is doing everything." ~ C.S. Lewis

What do you think? Who controls birth?

Monday, July 26, 2010

The Home Birth Controversy

Depending on who you talk to, home birth is either the best thing you can do for the safety of your baby, or the worst. Who are we to believe?

Home Birth has been in the news a lot lately. Just one day after legislation was passed in New York allowing midwives to practice independently of physicians, a meta-analysis of home birth studies was publicized by the American Journal of Obstetrics and Gynecology, slamming home birth and claiming that home birth "triples risk of infant death". The Unnecesarean and the Midwife Next Door both chimed in, among others, refuting the meta-analysis and exposing it's faults.

One thing I like to remember is to recognize the source. If a study or analysis is being publicized by AJOG, which is the journal of the American Congress of Obstetrics and Gynecology, then it's going to favor the positions which ACOG has taken on issues. ACOG is a lobbying group, which serves to protect the interests of physicians and hospitals. Groups like the American Medical Association and ACOG have taken strong positions against home birth for a reason. They have financial interest in hospitals and doctors. They lose money when women choose to birth at home. If you read the scathing reviews on the recent meta-analysis you'll see that the analysis contradicts itself. The studies used in the analysis don't support the findings, and the analysis itself contains contradictory information.

You must look closely. Don't take things at first glance, and don't put stock in a catchy headline. Read and do your research. You may find, as I have, that modern obstetrics is not based on evidence. It's based on what's profitable and convenient for the system that's in place.

Do your homework. Read books, like "Get Me Out; A History of Childbirth from the Garden of Eden to the Sperm Bank", "Pushed" by Jennifer Block, "The Thinking Woman's Guide to a Better Birth" by Henci Goer. Watch "The Business of Being Born" by Ricki Lake and Abby Epstein. Read any of the books written by Ina May Gaskin.

Jennifer Block wrote a really good piece: The Birth Wars: Who's really winning the home birth debate?

We see so much about hospital birth because 99% of babies are born in the hospital in the US. If you want to learn about the safety of home birth, you have to look for it and find the sources. Here are some you can start with:
Ultimately, it is YOU who must decide what's best for you. After you've done your research and educated yourself, search yourself and see what feels best in your heart. I believe that intuition can guide us to make the best choices. Avoid making a choice based on fear. This is where the education comes into play. When you're fully informed, you have no need to fear. If you feel peace about home birth, then you know it's a good choice for you. If you still have doubts or fears about it, keep researching and reconsidering until you come to a decision you feel comfortable with.

Busca on Birth Faith posted a really interesting piece about the irrelevance of the place of birth: The irrelevance of home vs hospital. She states that the place of birth is less important than the support a woman receives through labor and birth. I personally feel that both are equally important, but you must come to your own opinion.

You may decide that home birth isn't for you. You want or need to be in the hospital, but you want it to be a beautiful experience. There is a book called Homebirth in the Hospital, which can help you plan and prepare for a beautiful hospital birth.

Sunday, July 25, 2010

Great Post on Group B Strep

Sheridan at Enjoy Birth has written a great blog post about Group B Strep: Group B Strep - Why Should I Care? It's full of resources so you can educate yourself and make an informed choice in your prenatal care.

Friday, July 23, 2010

ACOG Issues Less Restrictive VBAC Guidelines

This has just been released by ACOG this week. It's far from perfect, but definitely a step in the right direction!

This is huge. Very important information for women and their care givers regarding vaginal birth after cesarean. Due to copyright issues I'm not including any direct quotes from the article. Please read the article here:

For information on the impact of the new guidelines, click here.

Wednesday, July 21, 2010

Breech Resources: Turning a Breech Baby

I love sharing information with the amazing mamas on my Mamas and Babies facebook page. I recently asked for some resources about breech babies, and I want to share those with you.

For information about the risks and options with breech babies, please see some of my past posts on the subject:
  • Spinning Babies is the first resource I think of when someone asks about turning a breech baby. It's full of information and tips, and I'm honored that they have a link to my own breech birth story.
  • Stand and Deliver has some really great posts about breech: The Dance of the Breech (which has amazing illustrations and descriptions of how to catch a breech baby), and International Breech Conference, Day 1 and Day 2.
  • The Times Colonist has a great article about Canadian doctors no longer doing automatic c-sections for breech babies. They are, in fact, trying to teach physicians how to attend vaginal breech birth.
  • Traditions in Prenatal Care has a transcript of a radio show on which they discussed breech babies and a technique called "sifting" that can be used to help turn a breech baby into a head-down presentation.
  • Here's a website that has 17 ways to turn a breech baby.
  • The ICPA has some information about the Webster Technique, which is a method that chiropractors can use to attempt to turn a breech baby.
  • And last, if you're on facebook and want support and interaction with other moms of breech babies, you can look up Breech Birth.
Only 3-4% of babies will not turn head-down before birth. Most babies will be vertex and in the optimal position for birth. But for the small percentage who don't, we need to know how to help them, whether by turning before labor begins or in assisting with a vaginal breech birth.

If you have any additional information or resources about breech babies, please share them! I have a special place in my heart for breech babies.

Monday, July 19, 2010

Kangaroo Care

Human Nature
Mother's Touch
by Ashley Montagu

Human kids and kangaroo kids have more in common than you might think. By studying marsupial mothering, researchers are gaining valuable new insights into the needs of vulnerable newborns.

A human body is not a finished product. The newborn elephant and the newborn fallow deer can run with the herd shortly after they are born. A six-week-old seal navigates the seas by itself. Human beings, however, can't even crawl until they are 8 to 10 months old; they can't walk or talk until they're about 14 months old. Why are human beings born more immature and why do they stay immature longer than any other animal?

Like the newborn marsupial that crawls over its mother's damp fur to her pouch, there to spend up to six months completing its development, the human newborn is only half-formed. It could be said that a child's birth is not an end of gestation but a bridge between growth within the womb and growth outside it. The elephant, deer, seal and human all have long gestation periods – ranging from an average period of 630 days for the elephant to about 266 days for humans. Yet only humans are born so immature, their growth divided into a period inside the womb (uterogestation) and a period outside the womb (exterogestation). It appears that if babies weren't born when they are, they couldn't be born at all.

At birth, the brain of the average seven-pound infant weighs roughly 380 grams. To be as talented and capable as a newborn elephant, deer or seal, the human infant would need the 825-gram brain of a one-year old. Clearly, infants can't wait until they've grown a brain that big before being born – their heads would be too large to fit through the mother's birth canal. They must be born with the biggest possible brain that still allows them to get out and then do the rest of their brain-growing after birth.

As Professor John Bostock of the University of Queensland, Australia, suggested, what I call the period of exterogestation is over when a child can crawl on all fours. Amazingly, the average time for this achievement is 266 days – exactly the same length as the average pregnancy.

Two-stage gestation might have been an adaptation to several important changes during the early evolution of the human species. The move from the forest to the open plains demanded an erect posture and a bigger brain. The pelvic outlet grew smaller while the brain grew larger.

If this two-stage theory of gestation is sound, then we are not adequately meeting the needs of infants. We fail to give attention to gestation outside the womb.

The human infant is almost as immature as the infant opossum or kangaroo, but whereas the marsupial infant enjoys the protection of its mother's pouch, the human infant has no such advantage.

The symbiotic relationship maintained by mother and fetus throughout pregnancy should not end at birth; indeed, it is naturally designed to become more intense during exterogestation. The mother who is equipped to give sustenance and shelter inside the womb is equipped to do so outside the womb, at least as efficiently as the marsupial mother.

The warmth with which the mother enfolds her child while breast-feeding is psychologically analogous to the pouch enclosing a suckling marsupial. However, little marsupials, with free access to their mother's breast, suckle when they wish; human infants are generally suckled when their mothers think they should be. Children are therefore in a much more dependent, indeed more hazardous, state than marsupials; they should be nursed on demand, rather than by the clock.

When the human mother breast-feeds her child, the pair make eye contact vital to the psychological development of the child. The mother lovingly coos, talks and sings to the child, cuddling, kissing and caressing it. As important as breast-feeding itself are its associated sensory stimuli – the sights, sounds, smells, taste and warm feelings that comprise the enfolding love that ought to be the birthright of every child.

Several studies show that early deprivation of maternal care leads, in many animals, to failure of both individual and social development. The human infant is in many ways more dependent on such sociopsychological care, not merely because it is born in such an immature state, but because becoming a competent human being is much more complicated than becoming a competent baboon.

Saturday, July 17, 2010

Controls Needed for Hyperemesis Gravidarum Study

I found this on Stand and Deliver: Controls needed for HG study

"We currently have almost 1,000 eligible participants for the HG study, but we have less than 500 friend controls. I'm writing to beg you to refer extra CONTROLS to participate in the study. A control is someone who has had at least 2 pregnancies and has not had any weight loss or treatment for nausea in pregnancy. The controls cannot be blood relatives. Please have any willing friend controls email me at and reference your name or ID number.

We are getting there but I need your help!!!

Thank you for helping me find the cause and cure for HG!

Marlena S. Fejzo, PhD"

Please pass the word on, and participate if you can.

Friday, July 16, 2010

Breastfeeding Advertising and Public Image

There's a new ad campaign by Best for Babies which describes breastfeeding as a miracle. "According to the ad, the real miracle isn’t the bra, but mothers, and their ability to make milk for their own and others’ babies."

The Best for Babes Foundation was established in 2007 to fight the barriers to breastfeeding, and to give breastfeeding a makeover by using mainstream marketing and branding.

I think this is much needed, and I'm really glad that breastfeeding advertising has had a makeover. The "Breast is Best" campaign wasn't able to really shift infant feeding mentality in the United States.

However, while I love the depiction of breastfeeding as a miracle, I can't help but wonder if it will have the desired impact in shifting views of breastfeeding. One potential problem I see is that it doesn't necessarily normalize breastfeeding. Afterall, if we want all mothers to breastfeed their babies, doesn't this mean we need to normalize breastfeeding for the public? If we tout breast as being best or being a miracle, are we successfully normalizing this amazing, beautiful, natural, NORMAL process?

What do you think? Does the new ad campaign portray the right image of breastfeeding? Do you think it will help normalize breastfeeding and shift public images about infant feeding? Is there anything that can be done to counteract the mass advertising by formula companies?

Do you know why breastfeeding is essential and formula is bad for babies? The Ultimate Breastfeeding Book of Answers by Dr. Jack Newman is an excellent resource. Dr. Newman explains why formula is bad, but the bulk of the book is dedicated to helping mothers overcome breastfeeding challenges and successfully nourish their babies the way their bodies were designed to.

There are real dangers of using infant formula, and this is something I think we should be advertising. Expose the risk of NOT breastfeeding, and then maybe we'll get the message across of how normal and essential breastfeeding really is. It may be controversial to come straight at formula as being bad for babies, but should we be walking on egg shells worrying about offending people, or should we be exposing the lies the formula companies have perpetuated?

Here is a video on the subject that I really like. What are your thoughts?

Wednesday, July 14, 2010

What Triggers Spontaneous Labor?

Yet more proof that nature knows best, and why it's generally best to avoid induction and wait for labor to start spontaneously.

As published on Science Blog

Fetal lungs provide a signal initiating labor, UT Southwestern researchers find

Dr. Carole Mendelson, Dr. Jennifer Condon and Dr. Pancharatnam Jeyasuria have found evidence that a substance secreted by the lungs of a developing fetus contains the key signal that initiates labor.

DALLAS – March 22, 2004 – A protein released from the lungs of a developing mouse fetus initiates a cascade of chemical events leading to the mother's initiation of labor, researchers at UT Southwestern Medical Center at Dallas have found.

The research, which has implications for humans, marks the first time a link between a specific fetal lung protein and labor has been identified, said Dr. Carole Mendelson, professor of biochemistry and obstetrics and gynecology and senior author of the study. The paper appears in an upcoming issue of the Proceedings of the National Academy of Sciences and is currently available online.

The initiation of term labor is carefully timed to begin only after the embryo is sufficiently mature to survive outside the womb. Previous studies suggested that the signal for labor in humans may arise from the fetus, but the nature of the signal and actual mechanism was unclear, Dr. Mendelson said.

In their study, UT Southwestern researchers found evidence that a substance secreted by the lungs of a developing fetus contains the key signal that initiates labor. The substance, called surfactant, is essential for normal breathing outside the womb.

"We found that a protein within lung surfactant serves as a hormone of labor that signals to the mother's uterus when the fetal lungs are sufficiently mature to withstand the critical transition to air breathing," Dr. Mendelson said.

"No one really understands what causes normal or preterm labor. There may be several chemical pathways that lead to labor, but we think that this surfactant protein, which is also produced by the fetal lung in humans, may be the first hormonal signal for labor," said Dr. Mendelson, who is co-director of the North Texas March of Dimes Birth Defects Center at UT Southwestern.

In humans the signaling protein, called surfactant protein A, or SP-A, also helps immune cells, called macrophages, fight off infections in the lungs of children and adults by gobbling up bacteria, viruses and fungi that infiltrate the lung airway.

"Women who go into preterm labor frequently have an infection of the membranes that surround the fetus, and the number of macrophages in the wall of the uterus increases with the initiation of preterm labor. When women go into labor at term, they also have an increase in macrophages in the uterus," Dr. Mendelson said.

This led the researchers to investigate whether there was a connection between what happens during normal labor at term and in infected mothers who go into early labor.

"This also raised the question: If bacterial infection can cause increased macrophage infiltration of the uterus in preterm labor, what is the signal for the enhanced macrophage migration to the uterus at term?" Dr. Mendelson said.

In mice, the developing fetal lung starts producing SP-A at 17 days gestation; full-term delivery occurs at 19 days. The developing human fetus starts producing SP-A in increasing amounts after 30 to 32 weeks of a 40-week normal gestation, at which time the baby's lungs are essentially developed. As the fetus "breathes" amniotic fluid in the womb, the protein is released into the fluid.

"The SP-A protein binds to macrophages in the amniotic fluid, macrophages that come from the fetus itself," said Dr. Jennifer Condon, a postdoctoral researcher in biochemistry and the study's lead author.

The macrophages, "activated" by the protein, make their way through the amniotic fluid to the wall of the uterus. Once embedded there, they produce a chemical that stimulates an inflammatory response in the uterus, ultimately leading to labor.

The researchers also found that injecting a pregnant mouse with SP-A before day 17 of the pregnancy caused the mouse to deliver early. Injection of pregnant mice with an antibody that blocks SP-A function caused them to deliver late.

Identifying the receptors on the macrophages to which the SP-A protein binds will be the next step, Dr. Mendelson said.

"We think that bacteria may be binding to the same receptor on the macrophages to cause preterm labor in women. The bacteria mimic the function of SP-A, initiating the chemical reactions that lead to premature labor. If we knew more about this receptor on amniotic fluid macrophages, we may be able to design therapies or inhibitors to block preterm labor," she said.

Other researchers participating in the study were Dr. Pancharatnam Jeyasuria, a research fellow in internal medicine and former fellow Julie Faust, now a medical student at Texas A&M University.

The research was funded in part by the National Institutes of Health and the Texas Higher Education Coordinating Board.

Monday, July 12, 2010

Infant Feeding Survey - Have Your Voice Heard About Formula

The Center for Science in the Public Interest is interested in learning about your experience with infant formula marketing. Please take this survey if you have had a baby or adopted an infant in the last four years:

You can take this survey regardless of how your infant was fed.

Friday, July 9, 2010

Hospital Bans Early Elective Births, Resulting in Fewer Surgeries and Healthier Babies

Hospital cuts C-section rate, leading to healthier babies
As published on

June 16 might seem like a great day to give birth, but planning a C-section, or being talked into it for convenience (of either the patient or the physician) may be bad for the baby. Tallahassee Memorial Hospital has decreased the number of preterm births--and thus admissions to neonatal intensive care units and infants with health problems--by cutting elective induction and C-sections over the last three years.

The hospital saw early delivery rates go from 44 percent to less than 37 percent. The statewide rate is 38 percent and has gone up yearly for the last few years; the national rate is 32 percent. The hospital has also reduced first time delivery C-sections from 22 to 15 percent--compared to 25 percent for Florida as a whole. A rate under 20 percent is considered good by childbirth advocates.

Many obstetricians think that deliveries in the 37th or 38th weeks are fine since they don't usually involve serious complications for the infants. They allow both patient and physician more control over their schedules, and inductions can allow physicians to see more patients in a day. But emerging research indicates that any birth before 39 weeks involves potential problems, including respiratory distress. The later the delivery, the fewer admissions of newborns to intensive care, and there is no increase in mortality by waiting until 39 weeks to induce or schedule a C-section.

The Tallahassee Memorial program was the brainchild of a neonatologist who saw a relationship between the sick babies he cared for and how many were delivered by elective inductions or C-sections. Now, physicians can't schedule deliveries before 39 weeks without a medical reason.

The hospital also recommends that physicians not induce until a woman's Bishop's scale score--related to fetal position and cervical dilation--indicates she's ready. Noncompliant physicians get reminders, and the hospital has few outliers among their obstetricians.

Other hospitals should take note: In April, The Joint Commission asked hospitals to start collecting data on prenatal care, including the numbers of near-term deliveries and first-time C-sections in mothers at low risk. It will soon set target rates for hospitals based on their data.

This is a great example of what a huge impact hospital policy can have on the health of its mothers and babies. It's important to ask questions and find out what the policies are at your hospital of choice.

Wednesday, July 7, 2010

The Real Risks of Pitocin

This article has been going around the internet like wildfire! I've read a lot about pitocin, but I never realized everything that was involved with its routine use, or the real risks. All expectant parents need this information.

"Pitocin – a very useful drug that improved obstetrics and gave us options to help women in ways we weren’t able to before!

"Pitocin – a very seductive drug that changed obstetrics, increasing risks to mothers and babies in ways that are often not even taken into consideration.

"Both of these statements are true – how can that be? I will do my best to explain this complex issue in a simple and straight forward way. Be warned…much of what you are about to read will probably be new to you because these are the things that aren’t being talked about!"

"Pitocin is a drug used to induce or augment labors here in the US. It is most often given via IV infusion, although immediately postpartum if an IV isn’t already in place it may be given as an intramuscular injection. It was created for the first time in 1953 and became available just 2 years later. Mothering magazine writes, “A survey by Robbie Davis-Floyd, a cultural anthropologist at the University of Texas, found that 81 percent of women in US hospitals receive Pitocin either to induce or augment their labors.” It has been said that only 3% medically require it." (emphasis mine)

I could copy the entire article into this post, but it would be better for you to read it at the source. Please read this important article about the real risks of pitocin:

Monday, July 5, 2010

"Hope is better than nothing"

Women in Charge blog wrote this. It really touched my heart, and I want to pass it on to my readers:

Hope is better than nothing
by Maria Iorillo

I keep thinking about Sara from Uganda. She runs a 15-bed clinic along with 2 other midwives. She receives $5 per delivery. Some women come for prenatal care and not too many people come postpartum. Once a healthy baby is born, most of her clients feel they don't need to return.

Sara came all the way to Washington, DC to represent the Ugandan Midwifery Association at the Symposium to Strengthen Midwifery. She received a scholarship to attend Women Deliver. The UMA has over 2000 midwives and was started in 1948 when the government tried to make midwives retire at 55. You can imagine what the midwives said to that! So they formed an organization to better represent themselves to the powers that be. Sara says the UMA is the best midwifery organization in the world.

When the Symposium was almost over, Sara was discouraged and asked me what would happen on the ground. On my last day with Sara, we were walking from store after I had bought chocolate for her to take home to her children. She was hopeful, particularly because I had just made a blog for her that morning. She wants to use the blog to tell the stories of maternal death in Uganda. She wants to post about the midwifery meetings they will have. She has a new vehicle for communication. She is going home with SOMETHING already in her pocket. She says that hope is better than nothing. She says that she has a new friend, she has a blog, and that she knows that she is not forgotten. That the women of Uganda are not forgotten. Sara decided to call her blog, Women for Survival.

I keep thinking about Sara and our fast friendship. I am thinking about our partnership and how one-on-one we can help each other strengthen midwifery. I know so well how the Bay Area's midwifery community has grown simply because of the one-on-one support we give each other. Why can't we do that across the global? I guess I'm saying there's no reason why not.

Friday, July 2, 2010

The Dangers of C-section and Benefits of VBAC

I've recently come across quite a few articles and blog posts about c-sections and VBAC's, and I want to share them with you.

Dangerous delivery shows peril of multiple C-sections - This article may be a bit shocking, but I appreciate the candor about the risks of multiple c-sections. The old adage that "once a c-section, always a c-section" is not necessarily true, although many doctors and women still act like it is. The truth is that the more c-sections a woman has the more dangerous it is for her, and vaginal birth after a cesarean can be a viable option.

"The case points out a fundamental truth about surgical delivery: a first cesarean for most women leads to a cesarean with every pregnancy. And while a first section is quick, easy to perform, and rarely complicated, each repeat surgery carries greater risk."

Does Electronic Fetal Monitoring Increase the Rate of Unnecessary Cesareans? - This blog post on The Unnecesarean outlines something that I've read about in other books and articles: Electronic Fetal Monitoring is unreliable and leads to unnecessary c-sections. You know those belts and monitors that are strapped on a laboring woman in the hospital? One of those is the EFM monitor, and that's the culprit we're talking about. If you haven't heard about this risk before please, PLEASE read this post.

"There are numerous reasons that one of three U.S. births now is by cesarean, but Dr. Alex Friedman blames some on an imprecise monitor strapped to laboring women. Too often, he has sliced open a mother’s abdomen fearing the worst, only to pull out a pink, screaming bundle."

"'Everyone knows it’s a bad test,' said Friedman of the Hospital of the University of Pennsylvania. 'You haven’t done the patient a big service by doing an unnecessary surgery.'”

A Doula’s Journey to Vaginal Birth after Three C-Sections - This is a really cool post written by a doula who had a successful VBAC (Vaginal Birth After Cesarean) after 3 prior c-sections. She tells her story, her journey, and how she came to experience what she has supported other women in experiencing in her years as a doula. It's a really beautiful story

Dr. Poppy Daniels Surprise VBAC - Dr. Poppy Daniels had scheduled her third c-section and ended up with a surprise VBAC on the same day her surgery was scheduled to happen! I love her perspective as a doctor who is supportive and trusting of women's bodies to birth babies without intervention. She also explains her journey and how she came to have a beautiful surprise vaginal birth.

International Cesarean Awareness Network - For more than just anecdotal evidence, go here for VBAC information and support. ICAN has local support groups everywhere to help women meet and support each other.