raving_liberal
17 June 2009 @ 11:01 am
ACTION ALERT - Mead Johnson's "Breast Milk Formula"  
June 16, 2009


Formula company Mead Johnson has sunk to a new low with the launch of a website
http://www.enfamil.com/app/iwp/enfamil/productDetail.do?dm=enf&id=/Consumer_Home2/Enf_Products/ForInfants/EnfamilLIPIL2&iwpst=B2C&ls=0&csred=1&r=342227760
promoting its Enfamil brand. The website, targeted at U.S.
consumers, is entitled "The Breast Milk Formula - Enfamil" and uses the
slogan "Our closest formula to breastmilk." The company claims that its
formula produces health outcomes "similar to breastfed babies". As evidence,
Mead Johnson cites a study conducted in 2007 that supposedly showed that
babies fed on Enfamil had eye development virtually identical to breastfed
babies. The company calls this study "independent" research, and yet the
study was carried out by the Retina Foundation of the Southwest in Dallas,
TX. According to the Retina Foundation's 2007 annual report, Mead Johnson
gave the foundation over $100,000 the year that the study was published. How
is this independent?

This marketing campaign is a blatant case of false advertising. Because this
is a site originating in the United States and aimed at American consumers,
it is regulated in the United States by the Federal Trade Commission. Anyone
(including Canadians) can lodge a complaint with the FTC by visiting
https://www.ftccomplaintassistant.gov/. They have a quick online form set up
which only takes a few minutes. Most of the fields will not apply to this
particular complaint, but at the end you can make your case against Mead
Johnson.

[ETA: Here is Mead Johnson's contact information for the form, if you want:
Mead Johnson Locations
Location Type: Headquarters
2400 W. Lloyd Expwy.
Evansville, IN 47721-0001
United States (Map)... Read More
Phone: 812-429-5000
Fax: 812-429-7538
http://www.meadjohnson.com]

Please take the time to lodge a complaint with the FTC and help stop this
aggressive and misleading marketing. You might want to adapt the following
text for the final section of the form:

Mead Johnson Nutritionals is engaged in flagrant false advertising. They
have launched a website that calls their Enfamil brand the "Breast Milk
Formula", claiming that babies who are fed on it are as healthy as breastfed
infants. Scientific evidence points to the fact that formula-fed babies are
at increased risk for infections and long term illnesses such as cancers,
obesity, diabetes and cardiac disease. Contrary to what Mead Johnson's
website states, the negative effects of artificial feeding include decreased
visual acuity and reduced cognitive development. Aggressive and false
marketing like this has resulted in only 13% of U.S. mothers meeting expert
recommendations to breastfeed exclusively for the first 6 months of their
child's life. Please take action to stop Mead Johnson's deception.

The website in question is:
http://www.enfamil.com/app/iwp/enfamil/productDetail.do?dm=enf&id=/Consumer_Home2/Enf_Products/ForInfants/EnfamilLIPIL2&iwpst=B2C&ls=0&csred=1&r=3422636949
 
 
raving_liberal
12 June 2009 @ 02:54 pm
AMA Resolution Would Seek to Label “Ungrateful” Patients  
AMA Resolution Would Seek to Label “Ungrateful” Patients

Redondo Beach, CA, June 11, 2009 - At the American Medical Association’s (AMA) Annual Meeting next week, delegates will vote on a resolution which proposes to develop CPT (billing) codes to identify and label “non-compliant” patients (1)

The resolution complains:


“The stress of dealing with ungrateful patients is adding to the stress of physicians leading to decreased physician satisfaction.”

“This resolution is alarming in its arrogance and its failure to recognize, or even pay lip service to, patient autonomy,” said Desirre Andrews, the newly elected president of the International Cesarean Awareness Network (ICAN).

If approved, the resolution could hold implications for women receiving maternity care. For pregnant women seeking quality care and good outcomes, “non-compliance” is often their only alternative to accepting sub-standard care. Physicians routinely order interventions like induction, episiotomy, or cesarean section unnecessarily.

Liz Dutzy, a mother from Olathe, Kansas, delivered her first two babies by cesarean and was told by her obstetrician that she needed another surgical delivery. “My doctor told me that I needed to have a cesarean delivery at 39 weeks, or my uterus would rupture and my baby would die.” She sought out another care provider and had a healthy and safe intervention-free {home} birth at 41 weeks and 3 days gestation.

A recent report by Childbirth Connection and The Milbank Memorial Fund, called “Evidence-Based Maternity Care: What It Is and What It Can Achieve ,” (2) shows that the state of maternity care in the U.S. is worrisome, driven largely by a failure of care providers to heed evidence-based care practices. For most women in the U.S., care practices that have been proven to make childbirth easier and safer are underused, and interventions that may increase risks to mothers and babies are routinely overused. The authors of the report point to the “perinatal paradox” of doing more, but accomplishing less.

The resolution proposed by the Michigan delegation of the AMA could threaten patient care and patient autonomy for several reasons:

• Billing codes that would categorize any disagreement and exercise of autonomy on the part of the patient as “non-compliance” “abuse” or “hostility” could create a pathway for insurance companies to deny coverage to patients
• Use of these labels fails to recognize patients as competent partners with physicians in their own care
• Tagging patients as “non-compliant” fails to recognize that there is not a “one size fits all” approach to care, that different opinions among physicians abound, and that patients are entitled to these very same differences of opinion
• Labeling patients as “non-compliant” may, in fact, be punitive, jeopardizing a patient’s ability to seek out other care providers

The resolution also fails to address how it would implicate patients navigating controversial issues in medical care, like vaginal birth after cesarean (VBAC). While a substantive body of medical research demonstrates that VBAC is reasonably safe, if not safer, than repeat cesareans, most physicians and hospitals refuse to support VBAC. (3) The language in the resolution suggests that patients who assert their right to opt for VBAC could be tagged as non-compliant, even though their choice would be consistent with the medical research.

“The reality is that the balance of power in the physician-patient relationship is decidedly tipped towards physicians. The least patients should have is the right to disagree with their doctors and not be labeled a ‘naughty’ patient,” said Andrews.

About Cesareans: When a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. Potential risks to babies from cesareans include: low birth weight, prematurity, respiratory problems, and lacerations. Potential risks to women include: hemorrhage, infection, hysterectomy, surgical mistakes, re-hospitalization, dangerous placental abnormalities in future pregnancies, unexplained stillbirth in future pregnancies and increased percentage of maternal death.

Mission statement: ICAN is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean. ICAN has 110 chapters in North America and Europe, which hold educational and support meetings for people interested in cesarean prevention and recovery.



(1) Resolution 710 “Identifying Abusive, Hostile or Non-Compliant Patients”

(2) Evidence-Based Maternity Care: What It Is and What It Can Achieve

(3) http://www.ican-online.org/ican-in-the-news/trouble-repeat-cesareans

Resolution 710 text )
Tags:
 
 
raving_liberal
07 April 2009 @ 07:31 pm
It's a contest...a YARN contest  
Go here and comment for a chance to win a $20 gift certificate to Three Irish Girls!
 
 
raving_liberal
03 April 2009 @ 11:38 pm
All my babies' birth stories  
Just creating an public entry to have the links to them all in one place for tagging and future reference:

Liam's Birth, 11/28/00 -- 9lb, 21.5 inches long.
Donovan's Birth, 6/9/06 -- 8lb 3oz, 19.5 inches long.
Rosaline's Birth, 3/27/09 -- 9lb 4oz, 21 inches long.
 
 
raving_liberal
03 April 2009 @ 10:00 pm
New AAP Recommendation: Keep your toddler rear-facing until age 2  
Link here at the AAP online newsletter.

Keep your toddler in a rear-facing car seat until age 2 (not 1)

New research indicates that toddlers are more than five times safer riding rear-facing in a car safety seat up to their second birthday. Following are some safety tips for car seat use:

All infants should ride rear-facing in either an infant car seat or convertible seat.

If an infant car seat is used, the infant should be switched to a rear-facing convertible car seat once the maximum height (when the infant’s head is within 1 inch of the top of the seat) and weight (usually 22 pounds to 32 pounds) have been reached for that infant seat as suggested by the car seat manufacturer.

Toddlers should remain rear-facing in a convertible car seat until they have reached the maximum height and weight recommended for the model, or at least the age of 2.
To see if your car seat is installed properly and to find a certified passenger safety technician in your area, visit www.seatcheck.org or www.nhtsa.dot.gov/cps/cpsfitting/index.cfm. You also can call 866-SEATCHECK (866-732-8243) or 888-327-4236.
 
 
raving_liberal
10 March 2009 @ 06:27 pm
Harry Potter: relevant to everything, including breastfeeding  
‘Voldemort’ approach failing mothers
Monday 9 March 2009

Formula feeding should be clearly named in research showing its potential health risks to babies, according to a new study.

The study, led by Dr Julie Smith from the Australian Centre for Economics Research on Health at The Australian National University, shows that researchers reporting poorer health among formula-fed children too often shy away from including a mention of formula feeding in their titles or summaries.

“This is not helping properly informed health professionals and mothers,” Dr Smith said. “We looked at the findings of nearly 80 authoritative studies, all of which highlighted that formula-fed babies tend to be at higher risk of poor health than children fed on breast milk.

“Yet the vast majority of these studies did not mention formula feeding in the places that matter most for lasting impressions: headlines and abstracts. Rather than naming formula feeding as a significant risk factor, researchers seem to be treating this subject like Voldemort in the Harry Potter novels, as “He Who Shall Not Be Named.” For example, a study showing a higher incidence of a serious condition in formula fed infants was misleadingly named ‘Breastfeeding and necrotising enterocolitis,” she said.
Dr Smith and her colleagues stress that their research into how formula feeding is referred to in scientific studies was intended to ask an important rhetorical question about cultural attitudes and informed choice, and shows why blaming mothers for not breastfeeding is futile and misguided. They argue that initiatives to improve infant health by increasing breastfeeding have described the importance of accurate language, and the key role that well-informed health professionals play for women to breastfeed successfully.

“How can we expect physicians and other health professionals to be informed and convincing about the importance of breastfeeding if they themselves are not getting the facts on risks of formula feeding presented in a prominent and clear fashion?” Dr Smith said.

“Adopting the ‘Voldemort’ approach to describing the risks of formula feeding in published research harms the ability of physicians and other health professionals to support women, and reduces women’s ability to make informed choices. If a mother seeks support and reassurance that continuing breastfeeding is worthwhile, such non committal research reporting means she may get non committal advice from health professionals, even though the evidence is clear that formula feeding disadvantages infant health.”

Filed under: Media Release, ANU College of Medicine Biology and Environment, Health
Learn more: The research paper is online at http://www.acerh.edu.au/publications/ACERH_WP4.pdf
Contacts: Dr Julie Smith 02 6241 8861, 0416 099 630; Simon Couper, ANU Media Office 02 6125 4171, 0416 249 241


Another article on the same study but without the cute title. :)
 
 
raving_liberal
28 February 2009 @ 02:57 pm
Cutting back  
I've added quite a lot of people lately and have pretty much accepted any request to be friends. The end result has been that in some cases personalities haven't necessarily meshed that wonderfully and overall that I now have WAY too many people on my list, making it too difficult to keep up with everyone. I've scaled my friends list back a bit and will likely be trimming it back even further in the future. It's not a commentary on whether or not you're a decent person. It's just about what I can and cannot manage on my friends list right now.
 
 
raving_liberal
20 February 2009 @ 09:33 pm
Birth Supplies update (mostly for my own reference)  
Stuff I have:
cloth postpartum pads (including one sealed in a bag in my birth kit)
prefolds (clean and sealed w/ towels for postpartum bleeding)
cloth nursing pads
old towels (clean and sealed in a bag)
extra set of sheets
waterproof mattress cover
waterproof crib pads (2) to put under my side of the bed
fetoscope
gauze pads
Shepherd's purse in case of moderate post-partum bleeding
3 misoprostol pills in case of severe post-partum hemorrhage
rubber backed red rugs (2) to sub as chux pads just in case
1 reusable Chux pad
Pack of disposable Chux pads
Ziplock bags for sealing sterilized items
plastic umbilical cord clamps (2)
mesh panties (2)
peri bottle + comfrey for post partum peri care
herbal cord care (for the umbilical cord) + extra goldenseal
receiving blankets
bendy straws
Emergen-C
alfalfa
stainless steel scissors (sterilize, put in sealed bag)
birth ball
white grape juice (for homemade Laborade)
Feme pads (peri ice packs) and gauze covers

Stuff I need from To Ma To Japanese grocery:
miso soup paste
seaweed (in case of a tear)

Buy fresh to have in house:
light food to nibble
 
 
raving_liberal
02 February 2009 @ 04:16 pm
Birth Safety as a Binary Condition  
"Your baby is healthy and that's all that really matters."

How many times have you heard it or some variation of it? How many times have you said it or something like it? A new mom is struggling to make sense of a traumatic or confusing birth experience, to come to terms with unplanned interventions, perhaps an instrumental vaginal delivery or cesarean section that she'd never imagined she'd have. When she expresses her sorrow over the loss of the birth she had hoped for, the beautiful event she'd imagined, too often the response is, "At least you have a healthy baby." Christy Fiscer's essay, "A Healthy Baby Isn’t All That Matters", addresses this troubling tendency to trivialize a woman's birth experience by implying she isn't grateful enough that her baby is "healthy" (which really equates to "not dead or noticeably damaged") or that she's selfish for wanting, let alone expecting, more from birth than to be treated like an insignificant baby-bearing vessel. Seeking meaning in birth outside of a "healthy" newborn is viewed as frivolous, and women seeking empowering birth experiences are portrayed as solely being out to prove something or expecting to "get a medal for going without drugs." There's no need for me to rehash in great detail something that Christy has already addressed so passionately and eloquently. The "healthy baby is all that matters" attitude is merely one facet of a larger flaw in how our culture views birth outcomes.

The other day, someone left a comment [which was deleted due to the comment's author, not the comment's content] on my essay about "bravery" not really being a factor in choosing a homebirth to the effect that, if maternal and neonatal mortality outcomes of homebirths and hospital are nearly identical, that neither hospital birth nor home birth was more or less dangerous. I found this to be an interesting interpretation of the Johnson & Daviss study. While it's true that outcomes in terms of mortality rates were nearly identical, what made the study relevant to my essay was NOT that it showed a difference in the number of deaths, but that the low rate of mortality in the homebirth group was achieved with significantly fewer interventions than that of the hospital birthing group. If safety is measured by number of deaths alone, I suppose this would indicate that neither hospital nor home is more "dangerous" than the other, but is "not a lot of people died" really all that we're going for?

When did "didn't die" become our only barometer for success in childbirth? Baby was born/extracted from womb, both mother and child survived, therefor all is well, regardless of whatever other steps may have been involved in that birth/extraction process, regardless of any long-term harm (or increase in risk) to the mother or child, and regardless of the way anyone feels about the experience. Mom and baby lived; most studies would consider that a positive outcome. From a purely statistical standpoint, the birth was a success. This is certainly how birth is judged in this country from an obstetrical standpoint, but are we really satisfied as individuals with this binary notion of birth wherein "bad" is defined only as "dead" and "good" is defined only as "not dead"?

If a living mother and child are all that is required for birth success (or if, indeed, a healthy baby is the only thing that matters) then yes, hospital birth is "just as safe" (or "equally dangerous" or "no more dangerous," choose whichever language you prefer). If you start measuring safety and success by something more than a binary "live or die" condition, however, then you find disparity in outcomes.

What do many homebirth advocates view hospital birth as dangerous? It's not because more women die in hospitals, or because more babies die in hospitals, but because the interventions performed in ever increasing numbers in hospitals can have a devastating effect on long-term physical and mental health. The increased likelihood of cesarean section for women giving birth in hospitals is a good example of what is perceived by homebirth advocates as a danger of hospital birth. Cesarean section is a major abdominal surgery. While some care providers like to present surgical delivery as "just another way to give birth," the reality is that the procedure introduces a host of new risks to mother, child, and future pregnancies. These risks are worthwhile if the cesarean section is necessary, as the World Health Organization says the procedure is for less than 15% of births, but the procedure is grossly overperformed in the United States. Can a woman who did not need a cesarean, but who was manipulated/pressured, legally forced, misled by care providers about the necessity of the procedure, or who experienced iatrogenic health complications (for herself or her baby) due to mismanagement or over-management of her birth, be said to have had a "safe" or "successful" birth experience, even if the immediate outcome of the surgery is that mother and child live?

Maternal mortality rates do not tell us if the mother who had a unneeded cesarean section went on to have more children (as cesareans can cause fertility problems). Maternal mortality rates do not tell us if she had other cesarean deliveries as a result of her primary c-section (as fewer and fewer doctors/midwives will attend VBACs and many insurance providers will not cover them), or what complications or outcomes came from that birth (as each additional cesarean section has increased risks over the previous cesareans). They do not tell us if she experienced uterine rupture during her VBAC or repeat cesarean as a result of scar tissue from the primary surgery (the risk of rupture for VBAC and repeat cesarean is nearly identical, at slightly less than 1%). They do not tell us if she experienced placental previa or accreta in later pregnancies as a result of her prior c-section (the risk of both is increased in women who had have c-sections). They do not tell us if additional surgeries had to be performed after birth to correct iatrogenic health conditions, such as damage to the bowels or bladder (rare, but possible). They do not tell us if she experienced post-traumatic stress disorder, postpartum depression, or sexual dysfunction (all more common among women who had unplanned c-section than women who had planned vaginal births or planned c-sections) as a result of the unexpected surgery. Maternal mortality rates don't tell us if the mother had difficulty breastfeeding (women who have c-section are less likely to breastfeed). The only thing that maternal mortality rates tell us is whether or not a woman died during or shortly after giving birth as a result of that birth. These rates say nothing about the dangers to a woman's long-term health, either physical or mental, that resulted from the cesarean section. These rates say nothing about the feelings of disappointment, guilt, confusion, anger, or fear experienced during or after the birth.

I could list every intervention more common in hospital births than homebirths and tell you exactly why I, as a homebirth advocate, feel the overuse and misuse of these interventions make hospitals a dangerous place for low risk women to give birth, but why beleaguer that point? The heart of the issue, for me, isn't to examine the individual interventions, or even the cumulative risks of the whole cascade of interventions, but to bring attention to how little a binary notion of birth location safety actually tells us about the safety of giving birth.

When a child is born, a new mother is made. The process of her making, the experience of her birthing, is a meaningful one. Statements like "a healthy baby is all that matters" marginalize the mother by implying that the she doesn't matter, that she is lacking in worth (either by comparison to her child or in general). Though every mother's primary concern is a healthy baby, the mother's own experiences are not suddenly made worthless or unimportant if that goal of a healthy child is attained. Defining birth outcome by whether or not the mother and her child lived is equally marginalizing of the mother, because this narrow definition doesn't allow for variations in personal experience, physical or mental health, non-mortal birth crises. This definition of birth success says that only life or death, not the process, has meaning, and that even if you were poked, prodded, injected, cut, dehumanized -- if you didn't die, well, you were actually "safe" the whole time. You were in no danger, because the end justified all the means.

I don't know about you, but I want more than that particular binary view of safety.
Tags:
 
 
raving_liberal
31 January 2009 @ 03:45 pm
"Brave" has nothing to do with it  
When hearing the news that I had my last baby at home and am planning to have this one at home as well, the first response from most people is, "You're so brave."

This has to be one of the most irritating things that people say to homebirthers. The implication is that birth is dangerous and that we are willing to take on a tremendous risk to do it anywhere but a hospital. It negates the research and planning that we've done to come to this decision. It makes the choice about balls, not brains. After all, homebirth is "dangerous." Hospital birth is "safe." Therefor, it must be bravado alone that would lead a woman to choosing such an option. Right?

In 2003, over 20% of women had their labors induced, with a rate closer to 40% in many hospitals, while that rate should not exceed 10% (and has remained at 10% in most industrialized nations). Inductions are approximately 5 times more likely among planned hospital births than planned homebirths. An 1999 American Journal of Obstetrics and Gynecology "Green Journal" review of 7000 inductions found that 3 out of 4 of the inductions were not medically necessary. Inductions are performed unnecessarily for estimated size of the baby (too large or too small), going past the estimated due date, amniotic fluid levels that are low but not critically low (correctable in nearly all cases by rehydration of the mother), rupture of membranes without immediate start of labor, the mother being dilated/effaced but not in active labor, or scheduling reasons on the part of the mother or care provider. Approximately 40-50% of inductions fail (depending on the induction method used and the mother's Bishop score), and most failed inductions end in cesarean section. Inductions increase labor pain and length, and create, among other problems, an increased risk of fetal distress, uterine rupture, and cesarean section.

But homebirth is "dangerous." Hospital birth is "safe."

Over 30% of women in the US have cesarean sections, while overwhelming research has led the World Health Organization to set an ideal standard rate of cesarean sections at 10-12%, with 15% being the rate where more harm is being done instead of good. Cesareans are performed at a similar rate across all risk groups, low to high. The cesarean rate for planned births at home or in an independent birthing center is approximately 4%. Cesarean sections increase the likelihood of maternal death by as much as 4 times, and have other immediate and long-term heath risks for mothers that include, but are not limited to, infection, bowel or bladder perforation, hysterectomy, future infertility, and increased risk of uterine rupture for future pregnancies. Risks for the baby include respiratory distress, fetal injury, prematurity (if result of schedule section or failed induction), and breastfeeding difficulties. Four of the greatest causes for the increase in cesarean section are overuse of interventions during labor, concern for malpractice/liability on the part of care providers, failed labor inductions, and "failure to progress" (labor not progressing fast enough or regularly enough for care providers).

But homebirth is "dangerous" and hospital birth is "safe."

The ACOG and AMA have both come out against homebirthing, calling it a dangerous trend and referring to it as a "fashionable, trendy, [...] the latest cause célèbre," and they paint a horrible picture of complications arising in low-risk pregnancies with no warning that cannot be handled anywhere but the hospital. Despite that, the most thorough study ever done on homebirth safety, Kenneth C Johnson and Betty-Anne Daviss's Outcomes of planned home births with certified professional midwives: large prospective study in North America, BMJ 2005;330:1416 (18 June), found that the outcomes of planned homebirths for low risk mothers were the same as the outcomes of planned hospital births for low risk mothers, with a significantly lower incident of interventions in the homebirth group. The Lewis Mehl Study of home and hospital births, which matched couples in each group for age, parity, education, race, and pregnancy/birth risk factors, found the hospital group had 9 times the rate of episiotomies and tearing, 3 times the cesarean rate, 6 times the fetal distress, 2 times the use of oxytocin for induction/augmentation, 9 times the use of analgesia/anesthesia, 5 times the rate of maternal blood pressure increase, 3 times the rate of maternal hemorrhage, 4 times the rate of infection, 20 times the rate of forceps use, and 30 times the rate of birth injuries (including skull fractures and nerve damage). Breastfeeding success rates are higher and postpartum depression rates are lower for planned homebirths.

But homebirth is "dangerous" and hospital birth is "safe."

The United States spends more per pregnancy/birth than any other country, the vast majority of women in the US give birth in hospitals, and yet the US's maternal death rate is the worst among 28 industrialized nations and the neonatal mortality rate is the second worst. The Netherlands, where 36% of babies are born at home, has lower maternal and neonatal mortality rates than the US. Denmark, where all women have access to the option for a safe and legal home birth, has one of the lowest maternal and neonatal mortality rates.

But homebirth is "dangerous," hospital birth is "safe," and Brutus is an honorable man.

I didn't choose a homebirth because I am brave. Bravery has little to do with it. If anything, I believe women who choose to give birth in US hospitals are the brave ones, because knowing what I know about our technocratic obstetrical system, I can't imagine voluntarily choosing an obstetrician and a hospital for anything but absolute medical necessity. My decision to homebirth wasn't made in a void, but based upon years of research. I wonder how much research the average woman puts into her hospital birth? Considering how many times I've heard someone say "I'm glad I was in the hospital because..." and then given as her reason a non-emergent situation (such as fetal size or nuchal cords), I'd say not that much.

Call me stubborn, because I wasn't willing to accept out of hand the culturally held belief that hospitals are safer. Call me an idealist, because I believe that birth can be a positive, safe, and empowering experience for child and mother. Call me a nonconformist, because I choose to birth at home in defiance of a powerful technocratic system. Call me outspoken, because I can't keep my mouth shut when I hear about yet another iatrogenic birth calamity. Call me a "birth nazi," because I believe it's the right and responsibility of every woman to educate herself about birth and take ownership of her birth experience.

But brave? Don't call me brave. "Brave" has nothing to do with it.
Tags:
 
 
raving_liberal
22 January 2009 @ 06:55 pm
Increase in severe obstetric complications may be caused by increase in c-section rate  
Severe Obstetric Complications on the Increase

By Serena Gordon
HealthDay Reporter
Wednesday, January 21, 2009; 12:00 AM

WEDNESDAY, Jan. 21 (HealthDay News) -- Although less than 1 percent of women giving birth experience severe complications, a new report shows the rate of such complications increased significantly between 1998 and 2005.

Problems such as blood clots, serious breathing difficulties, shock, kidney failure and the need for blood transfusions rose from 0.64 percent in 1998/1999 to 0.81 percent in 2004/2005.

"Our overall result was that morbidity rates for severe problems are low, but it's devastating when a mother has severe morbidity, and we did find that the trends were increasing," said study co-author Dr. Susan Meikle, a medical officer at the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Bethesda, Md.
ad_icon

Results of the study were published in the February issue of Obstetrics & Gynecology.

Using national data, the researchers assessed births between 1998 and 2005, as well as whether or not there were recorded complications. In 1998, the data included almost 35 million births, while in 2005, there were more than 39 million.

The study found the incidence of severe maternal complications increased. The biggest jump occurred in the need for blood transfusions, which went up by 92 percent. The next biggest increase was in pulmonary embolism, which increased 52 percent during the study period.

"Pulmonary embolism is a complication associated with any type of surgery, and it's a high contributor to maternal mortality," Meikle said.

The percentage of women in respiratory distress after delivery jumped by 26 percent, and the rate of women who needed mechanical ventilation went up by 21 percent. The rate of women with kidney failure after delivery increased by 21 percent during the study period.

Meikle said the researchers found that the increase in severe complications wasn't related to rising maternal age, but that some complications, such as the need for a blood transfusion, blood clots and shock, may be associated with an increase in the rate of Caesarean deliveries.

"This is an interesting study, but the database isn't complete," said Dr. Robert Welch, chairman of obstetrics and gynecology at Providence Hospital in Southfield, Mich. For example, he said, the study doesn't separate those who have elective C-sections from those who have to have one after hours of hard labor.

Still, he noted, this study highlights that the risks of C-sections "sometimes get downplayed. It's often taken as just a step above natural childbirth, but it is a major abdominal operation that needs to be respected, and hospitals need to be prepared to deal with severe complications."

Meikle added that there was an association between obesity and pulmonary embolism (a blood clot that travels to the lungs), but that the link didn't reach statistical significance in this study.

A second study in the same issue of Obstetrics & Gynecology, also suggested that additional weight can create more problems during delivery. This study looked at more than 10,000 teen births and found that obese teens had more than a fourfold increased risk of delivering by C-section compared to their normal-weight peers. Obese teens also had four times the risk of developing gestational diabetes, according to the study.


SOURCES: Susan F. Meikle, M.D., M.S.P.H., medical officer, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Md.; Robert Welch, M.D., chairman, obstetrics and gynecology, Providence Hospital, Southfield, Mich.; February 2009, Obstetrics & Gynecology
Tags:
 
 
raving_liberal
09 January 2009 @ 07:19 pm
This is to settle a discussion in [livejournal.com profile] parenting101  
Referenced here

 
 
raving_liberal
19 December 2008 @ 03:16 pm
Birth By The Numbers  
"Unfortunately, history shows that advancements in the practice of medicine and surgery are rarely obtained in a thoroughly rational manner, but that a period of undue enthusiasm, or even of almost reckless abuse, usually precedes the establishment of the actual value of a given procedure."

John Whitridge Williams, pioneer of academic obstetrics
Author of Williams Obstetrics, the leading text in obstetrics for over 100 years


In Birth by the Numbers, Eugene R. Declercq, PhD, Professor of Maternal and Child Health, Boston University School of Public Health, presents the sobering statistics of birth in the United States today.





Learn more about the short film Birth By The Numbers here.
Tags:
 
 
raving_liberal
16 December 2008 @ 04:33 pm
A great quote from Dr. Marsden Wagner  
"Most of the present care system for birthing women in the Unites States is designed not to assist the mother but rather to control her.

Doctors control women with fear. They have succeeded in convincing the great majority of American women that they cannot safely give birth outside the hospital; that nearly half of them have uteruses that are non-starters and need to have labor induced or augmented with powerful drugs; that up to two-thirds of them cannot tolerate labor pain and must be made numb from the waist down with an epidural block so they cannot feel the birth of their babies; that one-third of them cannot push out their babies but must have it pulled out with forceps or a vacuum or cut out by C-section. When we try to make women believe that they can't give birth without the help of men, machines, and hospitals, we take away their confidence and their belief in their own bodies -- and with their confidence gone, any feelings of power and autonomy also disappear. Women in the United States have become victims of a medical vision of female reproduction, and that needs to change. The most effective way to avoid this medicalization of birth is to stay away from where it goes on -- the hospital."

from Born in the USA
Marsden Wagner, M.D., M.S.
Former Director of Women's and Children's Health, World Health Organization
Tags:
 
 
raving_liberal
14 October 2008 @ 10:31 am
An ounce of prevention is worth a pound of cure  
Army of Women is trying to recruit one million volunteers to participate in research devoted to preventing breast cancer. You can learn more on their website. One of their current projects is a study to determine whether breastmilk samples can be used to identify a woman's breast cancer risk. Anyone can participate [looks like it's currently US only] in this study, as it only requires mailed samples of breastmilk.

It's so nice to see an organization whose focus in on the prevention, not just the cure!
 
 
raving_liberal
18 September 2008 @ 02:38 pm
All politics are local! Get involved from you own home.  
I just spent the last twenty minutes writing ten postcards for Obama. I could do it from my bed, it took very little time, and cost very little money. If you want an easy way to be involved with the Obama/Biden campaign, but don't like talking to strangers on the phone (I know I don't!), you should give this a try. The hardest part of the whole thing was finding a place that actually sells postcards!
 
 
raving_liberal
18 September 2008 @ 10:40 am
The Other Side of the Glass  
A birth documentary for fathers.



To make a donation to the film makers or to learn more, visit their website.
 
 
raving_liberal
18 August 2008 @ 12:01 pm
Good Morning America Cross-Nursing segment  


And the GMA radio segment:

 
 
 
raving_liberal
19 July 2008 @ 08:23 pm
Cloth diapers we have known and loved, part 1  
A pictoral history of Donovan's first year in cloth diapers.

Picture Heavy )