Midwifery-Related Events in Southern California

Birth Tales:
Stories of Amazing Births (submitted by midwives, apprentices, doulas and parents)

The Problem With Breastfeeding:

What if doctors discovered a substance so potent, it could prevent dozens of diseases and even reduce the risk of cancer? Breastfeeding contributes significantly to child health.

Maternal Death Rate Increases: blamed on changes in reporting

http://include.nurse.com/apps/pbcs.dll/article?AID=/20080421/NATIONAL02/80418020/-1/frontpage

Maternal Death Rate Increases
Robin Huiras
Monday April 21, 2008

Selected Paragraphs:

The maternal death rate has doubled in the past 10 years, but more women aren’t necessarily dying before, during, or after childbirth, researchers say. The numbers can be attributed to new reporting methods.

According to the Center for National Health Statistics’ Vital Statistics Report, which was released in January, the maternal death rate was 15 women per 100,000 live births in 2005 — a 100% increase compared to the 1996 rate of 7.5 deaths per 100,000 live births. But report co-author Donna Hoyert, PhD, says there’s more to the numbers than meets the eye.

“We think the main reasons for the increase is, since 2003, states have been adding a separate question (on death certificates) about whether there was a recent pregnancy,” Hoyert says. “In the past, that information was supposed to be reported in the cause of death section, but if nothing was reported about a pregnancy, we have no clue if hemorrhaging or other complications were related [to the death].”

Other states are expanding their definitions of maternal death from traditional causes, such as hemorrhage, preeclampsia, and blood clots. Fatal complications that occur more than 42 days and up to one year after delivery and deaths from external causes, such as unintentional injury and homicide, also are now included in the definition of maternal death, Hoyert says

Down Load PDF:

Los  Angeles Best Babies Network and Eisner Pediatric & Family Medical Center Partner to Expand CenteringPregnancy® in Southern California (from April 1, 2008 Los Angeles  Best Babies Network Perinatal e-News).

LA Best Babies Network will partner with Eisner Pediatric & Family Medical Center, to create a Southern California CenteringPregnancy® Consortium and to provide training for five clinics on the CenteringPregnancy® model of group prenatal care. Funding for the CenteringPregnancy® Consortium and training was provided by a $49,000 grant from the March of Dimes.

CenteringPregnancy® is designed to maintain the essential components of quality prenatal care by providing assessments, education and medical and psychosocial interventions, while empowering mothers-to-be to manage their own health care and learn from each other. CenteringPregnancy® creates an atmosphere and opportunities for peer group support to reduce the sense of isolation that participants may face in the medical setting and in their personal lives. As a result, the CenteringPregnancy® model is a proven standard for improving pregnancy outcomes and reducing preterm births1.

In the CenteringPregnancy® model, women join groups of 8 to 12 expectant mothers with similar due dates (partners are also welcome) for their prenatal visits. Within this nurturing environment, women actively engage in their pregnancy by learning self-care activities such as checking their own blood pressure and weight, as well as monitoring fetal growth and heartbeat with either their physician or a certified nurse midwife. Health topics are covered in group sessions with the provider and individually as needed; topics include: nutrition, exercise, childbirth, breastfeeding and parenting among others.

"The CenteringPregnancy® model offers much more than the traditional model in which expectant women have individual visits with their provider during the prenatal period," says Janice French, CNM, MS, director of programs for LA Best Babies Network. "CenteringPregnancy® participants report that they often learn more about their own health, and their baby's health by questions that others ask. The group discussions also provide important emotional support for women sharing the experience of pregnancy."

To learn more about the development of the Southern California CenteringPregnancy® Consortium or to learn how your clinic can apply for CenteringPregnancy® training, please contact Sandra Trinidad, MPH, RD, care quality program coordinator for LA Best Babies Network at (213) 250-7273, ext. 111 or STrinidad@LABestBabies.org
Reference

1. Novick, Gina. CenteringPregnancy® and the Current State of Prenatal Care. Journal of Midwifery & Women's Health, 2004:49:405-411.

BREASTFEEDING AND DISASTER PREPAREDNESS

By Cordelia Hanna-Cheruiyot, BA, CCE, CBA

Here’s an angle you may not have thought about:  breastfeeding and disaster preparedness. As a maternal child health advocate, I am thinking about what the population I serve would need in an emergency. You may have heard about the Chinese Police Officer who breastfed 6 babies in the aftermath of the earthquake in China. Well, in our culture, people would think that was obscene. However, during the Katrina episode in New Orleans, many babies and mothers were separated. Disaster Planners and rescue workers did not consider the biological needs of mothers and infants to remain together. One solution is mobilizing the breastmik supply. While sharing nursing and wet nursing  is considered taboo in our culture, We really need to rethink this - because mobilizing the breastmilk supply could be life saving in a disaster. Lessons learned from International public health planners in  lesser developed regions is that where there is famine and war and extreme poverty, breastmilk is often times the ONLY means of survival for infants. Also, did you hear the story about people who were shipwrecked in the ocean, and a lactating mom fed everyone on her breastmilk...even adults, and they all survived?! Breastmilk truly is the "milk of human kindness". Of course, we need to be mindful about contagious diseases spread through breastmilk and take precautions, but we need to realize that breastmilk is a valuable commodity in a disaster or crises, and we should think about mobilizing a "brigade of breastfeeding moms" during a disaster.

In Jennifer Block's bestselling book "Pushed", about childbirth in America, she writes about a hurricane in South Florida's affects upon one hospital. They were without power and so they could not do "business as usual". During that time, they decreased their c-sections and elective induction of labors dramatically because the hospital was so hot, women could not stand to sit in a hospital bed for 20 hours getting induced. The lesson learned was that the hospital was MORE efficient, not LESS efficient when they let women come in active labor, and they delivered faster too, freeing up more beds sooner. This could also be true of breastfeeding...when there is a lack of refrigeration and clean water, breastmilk is always the right temperature in the right quantity and quality at the right time, In fact, breastmilk has ensured human survival from Day One...So we really need to rethink our ideas about the "socially unacceptable" practice of shared nursing or wet nursing.
 

Food for thought.

Milkmen? Can men breastfeed?  
This article discusses lactation in men...it is very interesting:

http://www.unassistedchildbirth.com/miscarticles/milkmen.html

Download PDF version.

Slate Magazine’s article review on Rikki Lake’s film “The Business of Being Born”

Push!
Ricki Lake's valentine to the home-birth movement.
By Dana Stevens
Posted Friday, Jan. 11, 2008, at 6:07 PM ET

http://www.slate.com/id/2181860/

The Business of Being Born, a documentary directed by Abby Epstein and produced by talk-show host Ricki Lake, is a generous-spirited tribute to the practice of home birth. It's full of moving (and surprisingly ungross) filmed deliveries, including those by Epstein and Lake themselves. Unfortunately, the movie is also a propagandistic brief on behalf of the home-birth movement that's so selective in its presentation of information that it makes Michael Moore look like a fat lady in a blindfold holding a pair of scales.

Full Story in PDF

ACNM Talks with Cara Muhlhahn, CNM, Midwife Featured in
“The Business of Being Born”
http://www.thebusinessofbeingborn.com

Rikki Lake and Abby Epstein’s Film on Birth In America

http://www.midwife.org/Interview_with_Cara_Muhlhahn.cfm#emergency

An Interview with Cara Muhlhahn

ACNM Talks with Cara Muhlhahn, CNM, Midwife Featured in The Business
of Being Born, Rikki Lake and Abby Epstein’s Film on Birth In America
Click here for more on The Emergency Transfer Scene: What the Cameras
don't Show
An American College of Nurse Midwives www.acnm.org member featured in Rikki Lake's new birth documentary talks about the film and shares her personal calling to midwifery.

FIRST NATIONAL SURVEY OF WOMEN'S CHILDBEARING EXPERIENCES RESULTS ARE NOW AVAILABLE, LISTENING TO MOTHER'S SURVEY

The maternal health promotion organization, Childbirth Connection (formerly Maternity Center Association) did two landmark national Listening to Mothers Surveys in 2002 and 2006 which are valuable resources for understanding and improving women's childbearing experiences. They focus the discussion on views of those who care most about maternity issues: mothers themselves.
We invite pregnant women to read the report to help understand maternity experiences, set goals and make plans and decisions. New and experienced mothers can use this national profile to put your own experiences in perspectives.

Results of the second national Listening to Mothers Survey are now available.

Policy makers, administrators, clinicians, educators and others with responsibility for mothers and babies can use survey results to understand and improve the quality of maternity experiences.

Childbirth Connection invites others - including states, health plans and hospitals - to use and adapt the survey questionnaires to understand and improve the experiences of specific populations.
To view learn what mothers said about their birth experience go to:
Childbirth Connection's Listening to Mothers Survey

SAVE MOTHER’S LIVES IN CALIFORNIA

A Message From Dr. Michael Lu OF UCLA

 
Dear Colleagues,
 
I am writing to ask for your help in saving California Maternal
Quality Care Collaborative (CMQCC). CMQCC is a statewide initiative to reduce maternal mortality and morbidities and improve the quality and safety of maternal healthcare in California. Over the past few years, CMQCC has provided leadership and vision to the safe motherhood movement in California. Some of its current projects include a statewide maternal mortality review, statewide surveillance of hospital rates of maternal hemorrhage and infections, and development of maternal healthcare quality improvement toolkits, just to name a few.
 
The State Senate Budget Committee has eliminated funding for CMQCC
and other related safe motherhood projects for the next fiscal year.
The State Assembly is proposing a budget cut but not complete elimination of funding. Now it goes to the conference committee, which is meeting this Saturday to determine the fate of CMQCC and related programs.
 
As a member of the executive committee for CMQCC and a concerned
citizen, I am asking for your help to save CMQCC by taking any or all of the 3 actions below. Also, please forward this email to all the people you know and on your listservs; ask them to forward this email to all the people they know and on their listservs; we need as many emails as possible BEFORE THIS SATURDAY to save CMQCC.
 
Thank you very much for your help.
 
Best regards,
Michael

(click on the link to open the letters, both word and PDF formats.)
CMQCC_letter.doc
CMQCC_letter.PDF

Senate assembly_contacts2.doc
Senate assembly_contacts2.PDF

1. Please email conference committee members today.

 
To do so, you can 1) copy and paste the following email addresses to
the address line, 2) copy and paste the text below, and 3) send email.
 
senator.dutton@sen.ca.gov <mailto:senator.dutton@sen.ca.gov ,
Russell.lowery@sen.ca.gov <mailto:Russell.lowery@sen.ca.gov ,
senator.ducheny@sen.ca.gov <mailto:senator.ducheny@sen.ca.gov ,
Michelle.Cabrera@sen.ca.gov <mailto:Michelle.Cabrera@sen.ca.gov ,
assemblymember.laird@assembly.ca.gov
<mailto:assemblymember.laird@assembly.ca.gov ,
assemblymember.niello@assembly.ca.gov
<mailto:assemblymember.niello@assembly.ca.gov , todd.moffitt@asm.ca.gov <mailto:todd.moffitt@asm.ca.gov ,
emily.currin@asm.ca.gov <mailto:emily.currin@asm.ca.gov
 
  
2. If you have time, please also fax the attached letter to
conference committee members today. They count both emails and faxes.
Just print the letter on your letterhead, sign and fax. Fax numbers are attached.
 
3. I know some of you are not allowed to "lobby" by the nature of
your work, but if you could please forward this email to your friends and colleagues and to as many people as possible, I would really appreciate it.

For More Information, Contact:

Michael C. Lu, MD, MPH
Associate Professor
Department of Obstetrics & Gynecology David Geffen School of Medicine
at UCLA Department of Community Health Sciences UCLA School of Public
Health 650 Charles E. Young Drive S, CHS 36-070B Box 951772 Los
Angeles, CA 90095-1772

Tel: (310) 825-5297
Fax (310) 794-1805

E-mail: mclu@ucla.edu <mailto:mclu@ucla.edu

The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) asks the question “Is normal birth a thing of the past?” and gives guidelines from WHO for the management of maternity care, very similar guidelines to the CIMS Initiative. See full article below.

Normal Birth: A Thing Of The Past?
10 Jan 2008

Normal Birth: A Thing Of The Past?
10 Jan 2008

At a time when nearly one in three US births are cesarean and the rate of medical intervention in maternity care continues to rise, the January/February issue of the Association of Women's Health, Obstetric and Neonatal Nurses' Journal of Obstetric, Gynecologic and Neonatal Nursing (JOGNN) explores the evolution and implications of current high-tech birthing practices and offers nursing recommendations for a return to normal birth.

The "Reclaiming Normal Birth" issue features articles that explore evidence-based nursing practices to promote normal physiological birth - that is, birth that occurs naturally with minimal medical intervention. Also discussed is how to balance these care practices in today's current birthing climate where interventions have become routine.

According to the article, "Promoting, Protecting, and Supporting Normal Birth: A Look at the Evidence," six evidence-based care practices adopted from the World Health Organization (WHO) can be implemented by nurses to promote physiological birth:

- Care Practice 1: Labor begins on its own;

- Care Practice 2: Freedom of movement throughout labor;

- Care Practice 3: Continuous labor support;

- Care Practice 4: No routine interventions;

- Care Practice 5: Spontaneous pushing in nonsupine positions; and

- Care Practice 6: No separation of mother and baby.

The article reviews evidence surrounding each of these care practices and determines that interventions that are not medical necessary increase the risk of complications for mother and baby during birth. However, nurses, as the most prominent, hands-on caregiver in the labor and delivery environment, are in a unique position to reintroduce care practices that support normal birth.

In "The Emergence of High-Tech Birthing," Elaine Zwelling, RN, PhD, a perinatal nurse consultant with the Hill-Rom Company, details the transition from pregnancy and birth as a normal, intervention- free event to a high risk and high-tech event.

Zwelling makes the case that normal birth, as defined by the six parameters adopted from WHO, may be difficult to achieve in the United States today due to routine high-tech interventions.

"As the primary caregivers for women during labor, nurses often find themselves walking a fine line between the wishes of the consumers and the preferences of the women's medical care providers," states Zwelling in the article. She recommends that nurses strive to balance high-tech with high-touch rather than selecting one over the other.

Both articles make the case that hospitals are well-equipped for high-risk, complicated births, but not set-up for normal birth due to policies, protocols and physical infrastructure. Therefore, advocating for normal birth is a challenge for nurses in the current maternity care environment and will require dramatic changes in the typical American hospital.

Continuing Nursing Education Credit may be earned by nurses who read and complete an online post-test and evaluation for the article, "Promoting, Protecting and Supporting Normal Birth: A Look at the Evidence," by Amy M. Romano, MSN, CNM, a perinatal research and advocacy coordinator at Lamaze International, and Judith A. Lothian, RN, PhD, LCCE, an associate professor at the College of Nursing, Seton Hall University in South Orange, New Jersey.

AWHONN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

About JOGNN

The Journal of Obstetric, Gynecologic and Neonatal Nursing (JOGNN) is the bimonthly peer-reviewed journal of the Association of Women's Health, Obstetric and Neonatal Nurses.

About AWHONN

The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) was founded in 1969 and is the foremost nursing authority that advances the health care of women and newborns through advocacy, research and the creation of high quality, evidence-based standards of care.

AWHONN's 22,000 members worldwide are clinicians, educators and executives who serve as patient care advocates focusing on the needs of women and infants. A leader in professional development, AWHONN is the first and only association to be awarded the designation Premier Provider by the American Nurses Credentialing Center for innovation and excellence in Continuing Education.

Association of Women's Health, Obstetric and Neonatal Nurses

Article URL: http://www.medicaln ewstoday. com/articles/ 93533.php

Main News Category: Pregnancy / Obstetrics

Also Appears In: Pediatrics / Children's Health

Download the full Story in PDF

Thursday, 6 January, 2000, 02:11 GMT

Male pregnancy rollercoaster

http://news.bbc.co.uk/2/hi/science/nature/592025.stm

The developing foetus drives hormone changes

Men accompany the mother of their child on a nine-month hormonal roller coaster, it has been discovered.

The researchers found that in fathers, levels of cortisol, prolactin and testosterone changed significantly during their partners' pregnancies.
"The differences for mums were much more drastic, but the patterns were similar," says Dr Storey.
Testosterone dropped by 33% just after the baby's birth, and the lower levels of testosterone were associated with men becoming more parental, the researchers found.
Dr Storey speculates that a combination of behaviour and pheromones from a pregnant woman somehow prompts the father to prepare for the birth of his child: "There's something about the couple being together that sets the stage."
Crying on cue
The team also asked fathers about changes that might signal a "sympathetic pregnancy", such as fatigue, change of appetite and weight gain. Fathers who reported these symptoms also had higher prolactin levels and a steeper drop in testosterone than those who did not.
Finally, the researchers studied short-term changes. After giving a blood sample, volunteers listened to a six-minute tape of a newborn baby's cries and watched a video about the difficulties of learning to breastfeed. Thirty minutes later, their blood was sampled again.
The researchers found that both the men and the women experienced pronounced hormonal changes after exposure to the baby cues, with cortisol levels plummeting.

http://news.bbc.co.uk/2/hi/health/6973101.stm
Friday, 31 August 2007

Woman has second set of triplets

A woman in Ohio has given birth to her second set of triplets. Victoria Lasita and her husband Tim conceived both sets naturally, without fertility treatments that increase the chance of multiple pregnancies. "Holy smokes. Do you know what the odds of that are?" fertility expert Dr Glen Hofmann told the Cincinnati Enquirer. The chances of conceiving one set of triplets naturally were about one in 8,000, making the odds of having them twice far higher, he said. Having triplets once did not affect the chances of having triplets a second time, added Dr Hofmann, medical director of the Bethesda Center for Reproductive Health and Fertility. Casey Alexander was the first born at 1357 local time on Wednesday at just 4lb 2.5oz (about 1.9kg). He was followed by Caden Bradley, at 4lb 13.5oz (about 2.2kg) and Carson Charles, at 4lb 9.5oz (just over 2kg). You take what God gives you Victoria Lasita Their father, Tim, who witnessed the Caesarean birth, said: "Everybody seems to be doing well." He said it was still too early to know when the babies will be ready to go home and join their older siblings, Jessica, Jillian and Brian, who will soon turn four. The Lasitas have been married six years and have three grown children from previous marriages. But they decided they'd like "one more" after the birth of the triplets. "I guess we should have been more specific and said one more child, not one more set," Victoria said. The Lasitas will be changing about 150 nappies a week for the new triplets. Victoria said: "You take what God gives you. And this is what he's decided we can handle."

Triplets for woman with two wombs

Hannah's triplets were born from two eggs. Photo: SWNS A UK woman with two wombs is believed to be the first in the world with the condition to give birth to triplets. Hannah Kersey, 23, from Northam in Devon, had identical twins Ruby and Tilly, who were born from one womb, Grace, who was born from the other. The girls had to stay in hospital for nine weeks after being born seven weeks early by Caesarean, but have now returned home to their parents. The odds of having triplets from two wombs are about 25 million to one. The chances of a woman with two wombs having twins or two separate births is estimated to be five million to one. Against the odds Only 70 women in the world are known to have been pregnant in two wombs, reports suggest. The condition, which is actually called uterus didelphys, affects one in 1,000 women in the UK. In Miss Kersey's case, the babies were conceived from two eggs - one in each womb - which were fertilised at the same time by two different sperm. There are very few world firsts nowadays, but it may be one Consultant Dr Simon Grant, who delivered the babies One egg then divided, producing identical twins, while the other developed into a single baby. Hannah and her partner Mick Faulkner said they were "over the moon" at how healthy and happy the girls are. Hannah said: "They are three lovely and incredible children, all with very different personalities. "Gracie seems to be the ringleader - maybe because she grew up in her own womb. "Ruby is very laid back and quiet, happy to sit and watch what is happening around her. WOMB ABNORMALITIES Occur when the uterus fails to fuse normally during development Vary in severity - sometimes the division extends into the vagina Can cause fertility problems "Tilly, who was the baby that struggled to survive inside me, is a real fighter, wanting to keep up with her sisters and not be left out." Dr Simon Grant, a consultant at Southmead Hospital who delivered the babies, said: "There are very few world firsts nowadays, but it may be one." Mr Ellis Downes, consultant obstetrician and gynaecologist at Chase Farm Hospital in London, said: "It is quite amazing. Women with two wombs have conceived a baby in each womb before but never twins in one and a singleton in the other." Leading expert Mr Peter Bowen-Simpkins added: "For a woman to spontaneously conceive and give birth in this way is a real rarity. They have been extremely fortunate." Mr Richard Warren of the Royal College of Obstetricians and Gynaecologists said most cases occur naturally, but the condition can run in families. Hannah's mother and sister also have two wombs.

UK couple 'miracle' triplets joy

The triplets were born early but are now at home and doing well A midwife has beaten the odds by giving birth to three identical bouncing baby girls. It is thought the odds of naturally conceiving identical triplets could be as high as one in 200 million. After being born seven weeks early, Olivia, Gabriella and Alessia, have gained weight and are thriving at home. Carmella Testa, aged 23, from Peterborough and her fiancé Richard Rees found out they were expecting triplets at the 12-week scan. The blue-eyed girls were born by emergency caesarean in January after Miss Testa developed high blood pressure. It was three weeks before the couple were able to bring them home because weighing between 3lb 4oz (1.47kg) and 3lb 10oz (1.64kg) they had to be cared for in incubators. 'Shock' "I knew they would be identical because there was just one placenta, so they were from the same egg. I'm so overwhelmed when I see them. I can't believe they are mine and that they are perfect Carmella Testa "I was very shocked. They weren't planned. They were born on 9 January, two days after my birthday so they were a lovely present," said Miss Testa. Both parents have a history of twins in their families but not triplets. Her colleagues in Peterborough Maternity Unit gave her extra special treatment. "I'm quite small - only 5ft - so at the unit, they joked that out of all the midwives, it would have to be me that gave birth to triplets. "Everyone was great there. My three close friends delivered each of the babies." The girls have each now gained 7lbs (3.2kg) and are doing really well, although the couple admit life is now pretty hectic. "It's a miracle. I'm so overwhelmed when I see them. I can't believe they are mine and that they are perfect," she said. Identical triplets occur when one fertilised egg splits to create three separate embryos. Non-identical triplets occur when three separate eggs are fertilised. This is more common in women who have undergone fertility treatment.

Check this out.
A new survey of mothers reveals some disturbing things about hospital maternity care that may make pregnant women want to take a closer look at their options. See link below to full article.

What Women Aren't Told About Childbirth
http://www.alternet.org/healthwellness/65608

Or download the PDF file

The C-Section Epidemic

Did you see this article that appeared in the LA Times on Monday Sept.
24th? Finally, the connection between increased medicalized childbirth/C-Sections in the U.S. and the rise in maternal deaths is getting the attention it deserves!

For further information check out the Safe Motherhood USA website at:
http://www.rememberthemothers.org. The Safe Motherhood Initiatives-USA is a partnership of organizations whose goal is to reduce maternal mortality in the United States. SMI was launched on October 25, 1997, the Tenth Anniversary of the International Safe Motherhood Initiative.
They launched a quilt project; each patch has the name and birth date and death date of woman who died of childbirth-related causes. The quilt travels and can be brought to your venue -- a powerful tool to educate about this hidden crises in the US!

Read summary of article below and click on link for full article.

More women are dying in childbirth thanks to the high numbers of doctors and mothers who opt out of normal delivery.

By Jennifer Block

September 24 2007

Pre-term births are on the rise. Nearly one-third of women have major abdominal surgery to give birth. And compared with other industrialized countries, the United States ranks second-to-last in infant survival.
For years, these numbers have suggested something is terribly amiss in delivery wards. Now there is even more compelling evidence that the U.S.
maternity care system is failing: For the first time in decades, the number of women dying in childbirth has increased.

The complete article can be viewed at:
http://www.latimes.com/news/opinion/la-oe-block24sep24,0,6378847.story?c
oll=la-opinion-center

View in PDF format

For further information check out the Safe Motherhood USA website at:
http://rememberthemothers.net/.
The Safe Motherhood Initiatives-USA

Lamaze eNews:
March 2008 Planned Cesarean Surgery Is No Safer for Breech Births
Despite one study's conclusion that planned cesarean surgery results in superior outcomes for babies and equivalent outcomes for mothers, flaws in this research indicate otherwise. In "When Research is Flawed," obstetric research expert Henci Goer finds several problems in how the Hannah study—a randomized trial to compare planned cesarean surgery vs. planned vaginal birth for breech births was conducted and its interpretations of the results. Other studies, based on a good selection of patients, contradict these findings and report that with a good selection of patients, properly trained medical staff and careful management during labor, vaginal birth is safe for breech babies.
"When Research is Flawed," developed by the Lamaze Institute for Normal Birth, provides brief critiques of some of the most influential research studies published on topics that shape and affect policy and practice in maternal-child health care, such as breech birth. These research study critiques help childbirth professionals evaluate the quality of evidence and communicate that evidence to expectant parents, who may be misled or confused by information they receive from the media.
Read the complete critique on the Hannah study on breech birth, as well as critiques of studies on epidural analgesia, home birth, induction of labor and vaginal birth after cesarean (VBAC) at "When Research is Flawed" on the Research page of www.lamaze.org.

U.S. Maternal Mortality Rates on the Rise      
The U.S. maternal mortality rate rose to 13 deaths per 100,000 live births in 2004, according to a report released by the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics. By comparison, in 2003, the maternal mortality rate was 12 deaths per 100,000.

The CDC reports a total of 540 pregnancy-related deaths in 2004, 45 more deaths than in 2003. Some factors affecting the maternal mortality rate include:

·        Caesarean sections - Accounting for 29% of births, C-sections can cause excessive bleeding that may lead to death.

·        Obesity - Overweight women experience complications such as diabetes that can affect pregnancy outcomes.

·        Race - The maternal mortality rate among African-American women is three times greater than that of Caucasian women.

·        Quality of care - Approximately 40% of maternal deaths could have been prevented with appropriate prenatal care.

·        Age - Women that delay childbirth tend to experience pregnancy complications.

Learn more

View the CDC's report "Deaths: Final Data for 2004"
Download and view PDF

-Reprinted from perinatal e-news, LA Best Babies Network at www.labestbabies.org       

Pushed, a book by Jennifer Block,

Explores Reproductive Rights in the United States
Pushed: The Painful Truth about Childbirth & Modern Maternity, a new book written by Jennifer Block, takes readers on a journey across the country to investigate all sides of childbirth issues in the United States today. In this provocative, well-researched analysis of childbirth, Block witnesses several births—from a planned cesarean to an "underground" home birth—and explores the assumption that routine cesarean surgeries, inductions and epidurals equal medical progress. Read more of Block's incisive discussion on reproductive rights by purchasing Pushed at the Lamaze Bookstore & Media Center. Copies are available for $26 for non-members, and are available at a special discounted rate of $23.40 for Lamaze members.

This Concord Monitor Online article was sent to you from Cordelia (calenhad.publicus.com)

Article title: Backing at-home births
URL: http://www.concordmonitor.com/apps/pbcs.dll/article?AID=2008801170385

View as PDF

Look Inside a Lamaze Class
Do you or someone you know want to learn more about what happens during a Lamaze Childbirth Education Class or a normal birth? Lamaze International has developed a six-minute video called "Look Inside a Lamaze Class," which takes viewers on a journey through a childbirth education class and one mother's experience of normal birth. The video is a beautiful example of continuous labor support, and demonstrates how to implement a variety of comfort measures and position changes during birth.
View the video online or download it for FREE to your computer from the Lamaze Web site, so you can show it to friends, colleagues or in your childbirth education classes. You also can view the video on YouTube and add it as one of your favorites!

Maternal Mortality Up

U.S. women are dying from childbirth at the highest rate in decades.
The high cesearean rates are partly to blame. See full article by
clicking on link below. (This artcle does not bring out the fact that
African-American maternal mortality is 4 times higher than it is for
white Americans. A fact that has not changed in decades)

The rate of death in childbirth has risen, possibly due to more
besity and C-sections, but the risk is still small

THE ASSOCIATED PRESS

August 27 2007

U.S. women are dying from childbirth at the highest rate in decades,
new government figures show. Though the risk of death is very small,
experts believe increasing maternal obesity and a jump in Caesarean
sections are partly to blame.

Visit Newsday.com at http://www.newsday.com

Giving Infants a Helping Hand (Summarized from Newsweek)
p45 Spr-Sum 1997

Physical contact may also help preemies gain weight faster and healthy babies digest food better. 

Scientist's work with fragile neonates and preschoolers points toward the conclusion: that touch is vitally important to the development of healthy, happy children. Bolstering the immune system, cuddling and massage appears to have many positive effects.

At the University of Miami's Touch Research Institute, director Tiffany Field cites many studies on the effects of touch. "Premature babies given daily massage gain 47 percent more weight and are discharged from hospitals six days earlier - at a savings of $10,000 each in medical costs. Cocaine-addicted and HIV-infected newborns show lower levels of stress as well as say that better weight gain and motor skills with touch therapy. From colic to sleep disorders to hyperactivity, therapeutic touch seems beneficial. Says Field, 'Most of us think touch only has psychological benefits, but it's actually an important stimulus to the central nervous system."

Researchers found that newborn rat pups failed to grow when removed from their mothers. Without their mothers licking them, baby rats showed decreased levels of growth hormones. When a lab assistant imitated the mother's licking with a wet paintbrush, "hormone levels rose and the pups resumed growing". Likewise for human babies. Studies have shown that touching can also lead to weight gain. The pressure releases hormones that make food absorption more efficient -- and babies grow faster. Touch also decreases stress. Infants who receive massage show lower levels of the stress hormone in their urine -- a hormone that kills important immune cells at higher levels.

While many parents of preemies are seeing the benefits of infant massage, the medical establishment isn't always quite as enthusiastic. Many doctors stop short of prescribing massage to help babies grow or reduce their stress. Touch research is still relatively new. Many questions remain unanswered. Yet more and more neonatal intensive care units are beginning to add touch to their therapy, and parental interest in infant massage continues to grow.
So once again, science is catching up to the wisdom of a mother's intuition.

By Laurie Barclay, MD

[Complete author affiliations and disclosures, and other CME information, are available at the end of this article.]

May 1, 2008 — Skin-to-skin contact to reduce pain in preterm neonates has been shown to be effective in infants from 28 weeks of gestation through term, according to the results of a crossover trial reported in the April 23 Online First issue of BMC Pediatrics.

"Skin-to-skin contact, or kangaroo mother care (KMC) has been shown to be efficacious in diminishing pain response to heel lance in full term and moderately preterm neonates," write Celeste Johnston, DEd, RN, from McGill University School of Nursing in Montreal, Quebec, Canada, and colleagues. "The purpose of this study was to determine if KMC would also be efficacious in very preterm neonates."

Full Story: Click to Download PDF file

Pregnancy and Auto-Immune Disease
Summarized from an article in Self Magazine

It has long been a mystery why certain autoimmune diseases, like schroederma (in which the skin becomes increasingly hard), occur ten times more frequently in women than in men. Research now indicates that pregnancy may increase the risk of having autoimmune diseases because of a flux of fetal cells in the mother's bloodstream during delivery. Researcher Diana W. Bianchi, M.D. Chief of Genetics at the New England Medical Center in Boston, has harvested fetal cells from mothers up to 27 years after giving birth. This has given rise to the idea that not all "autoimmune" diseases are reactions to the cells of the body and may instead be related to the "foreign" genetic material still present from childbirth. If this hypothesis is proven to be correct, scientists might be able to formulate new and better ways to fight diseases such as schroederma.

Lamaze Institute for Normal Birth:
Why Transparency Matters: A Fact Sheet for Birth Advocates

Transparency means providing health care consumers with the information they need - and the means to interpret it - in order to evaluate the quality of care provided by individual providers and institutions.
Transparency is the missing ingredient to truly informed choice.

Click to learn more.

http://www.lamaze.org/Advocacy/BirthNetworksOrganizingYourCommunity/Tool
sTipsandResources/WhyTransparencyMatters/tabid/530/Default.aspx

Comments from Kimberly Durdin-James http://www.thecroneskitchen.blogspot.com):
Do you know of any women of color that have died within their their first year  after having a  baby, experienced a near-miss or suffered some type of morbidity related to birth? 
Amnesty International is conducting long overdue research to examine why black women IN THIS COUNTRY die after childbirth at a rate of 4X greater than white women and latina moms die at a rate of twice that of white women.  If you do know someone to whom this has occured Amnesty International would like to speak to you.  Read their brief below.  I'll also be doing a piece on my blog, hopefully by this weekend. http://www. thecroneskitchen.blogspot.com
 Peace and many blessings,
 Kimberly Durdin, IBCLC

Amnesty International is an international human rights organization that undertakes research and action focused on preventing and ending grave abuses of human rights, including the rights of physical and mental integrity, and freedom from discrimination. The organization has also increasingly been working on economic, social and cultural rights. Within the next year, Amnesty International is planning on launching a campaign focusing on achieving equal access to rights, including the right to health.

In this context, Amnesty International USA (AIUSA) is undertaking a research project aimed at documenting the rate and nature of maternal mortality in the US. The springboard for our interest is the fact that women in the US face a greater risk of maternal mortality than women in other industrialized countries.  Even more alarmingly, maternal mortality rates are four times higher for African American women than white women and twice as high for Latina women.  The research team is engaged in documenting and gathering information on a broad range of issues that relate to direct and indirect causes of maternal deaths - including the lack of accurate national statistics, access to care, absence of quality care for uninsured and underinsured women, issues of discrimination, the lack of national guidelines on maternal health and emergency care, as well as the issue of informed consent.  We are particularly interested in documenting the experiences of racial/ethnic minority women -- in particular African American and Latina women -- and women living in poverty and exploring reasons for the high rate of maternal mortality among these groups of women.

The research will be conducted through interviews, surveys, media research and literature review. AIUSA is planning to produce a report on its findings, providing an overview of issues concerning maternal mortality rates and women’s access to adequate and appropriate healthcare. The report will also contain recommendations on how women’s health outcomes can be improved based on interviews and input from experts, advocates, surviving family members and women who survived life-threatening pregnancy-related complications, building on the framework of international law and standards.

AIUSA is therefore reaching out to organizations and experts willing to share their knowledge and expertise. We are also seeking individuals willing to share their experiences.  Any information provided to us by individuals will be kept completely confidential, unless you and your client wish to bring attention to a particular case.  All organizations that participate in this project will be clearly credited in the final report, unless your preference is to remain anonymous.  We would also appreciate your input on developing recommendations to US authorities and on potential campaign activities, many of which we hope will be collaborative efforts.

We would very much appreciate the opportunity to meet with you.  Please contact us by email at rcho@aiusa.org, or by phone at 212-633-4161, if you would be willing and able to work with us in any capacity on this project.  Please do not hesitate to contact us for more information or if you have any questions.  We look forward to hearing from you soon!

Nan Strauss                                          Rosa Cho
Researcher                                           Research Fellow

The International Health Partnership Launched Today

A new international partnership was launched last week that will help build national health systems in some of the poorest countries in the world. It will mean healthier people, living longer lives. Seven ‘first wave’ countries in Africa and Asia today announced that they would join the new International Health Partnership, which is supported by donor governments and agencies representing half of the world’s aid spending on health, which totals $14 billion.  The seven in the first wave are Burundi, Cambodia, Ethiopia, Kenya, Mozambique, Nepal and Zambia. These countries have agreed that they would benefit from closer donor and international partner coordination as they work to improve the health of their people.

Down load the PDF to Read more

"How You Can Help Save Mothers' Lives :
Maternal mortality is the leading cause of death for women of reproductive age. Here are seven things you can do to make a difference."

Comments from Cordelia Hanna-Cheruiyot: cordelia@socalbirth.com

It is good to see that the mainstream media is starting to pay attention to this important issue that is the leading cause of death for women worldwide.  American women too are still dying from pregnancy-related causes. Though it is hard to believe this is still happening in modern times in a wealthy country like ours that boasts the most advanced technology and sophisticated medical treatment. The article addresses the disparities affecting Black women disproportionally; American Black women die from pregnancy and childbirth related causes at 4 times the rate of White women.

Click hear to down load the pdf to read more.

Is a Home Birth Unsafe? Thu Mar 6, 2008 3:54 pm (PST)
Vancouver Sun (BC, Canada) (02/27/08) Skelton, Chad

While some healthcare providers believe home births are riskier than
hospital births, research by University of British Columbia Perinatal Epidemiologist
Patricia Janssen indicates that those births handled by midwives often are
as safe or safer than hospital births. Janssen examined data on 800 planned
home births and 1,300 hospital births in British Columbia, publishing the
results in 2002; a follow-up study reviewing 3,000 planned home births in the
province from 2000 to 2004 has yet to be published. The 2002 report revealed that
11.9 percent of midwife-attended hospital births and 18.2 percent of
physician-attended hospital births involved Cesarean deliveries, versus 6.4 percent
of home births. Episiotomies occurred in 10.9 percent of midwife-attended
hospital births and 15.3 percent of physician-attended hospital births, but only
3.8 percent of home births. Additionally, 35 per 1,000 hospital births
involved infections, versus seven per 1,000 home births. According to Janssen, "In
a home birth you have the focused and undivided attention of an experienced
practitioner who may be able to pick up complications very early as opposed
to being in a crowded hospital where there's a mix of both experienced and new
practitioners who have other responsibilities. practitioners who have to
Columbia study indicates the importance of regulating midwives, as research from
countries that do not rigorously regulate home birth programs report higher
infant death rates and more complications