Interventions

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Fearing childbirth may prolong labor

http://thechart.blogs.cnn.com/2012/06/27/fearing-childbirth-may-prolong-labor/

Dr. Stuart Fischbein chuckled when he read the title of the press release: “Women with a fear of childbirth endure a longer labor.”

The release was promoting a study published this week in BJOG: An International Journal of Obstetrics and Gynecology.  Researchers at Akershus University Hospital in Norway found women who feared giving birth were in labor for 1 hour and 32 minutes longer, on average, than those who had no fear.

“I’m glad there’s now evidence to say that,” Fischbein said, “but it’s obvious.”

For those of us who aren’t OB/GYNs, it may seem more like a cruel joke. Women who are afraid of the pain and the possible medical complications associated with giving birth have to suffer through it longer?

(click link at top to read article on cnn.com)

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The Most Scientific Birth Is Often the Least Technological Birth

http://www.theatlantic.com/health/archive/2012/03/the-most-scientific-birth-is-often-the-least-technological-birth/254420/

If you look at scientific literature, you find over and over again that many interventions increase risk to mother and child instead of decreasing it. 

When I ask my medical students to describe their image of a woman who elects to birth with a midwife rather than with an obstetrician, they generally describe a woman who wears long cotton skirts, braids her hair, eats only organic vegan food, does yoga, and maybe drives a VW microbus. What they don’t envision is the omnivorous, pants-wearing science geek standing before them.

Indeed, they become downright confused when I go on to explain that there was really only one reason why my mate — an academic internist — and I decided to ditch our obstetrician and move to a midwife: Our midwife could be trusted to be scientific, whereas our obstetrician could not.

(click link at the top to read the rest of the article on TheAtlantic.com)

 

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Childbirth: What to Reject When You’re Expecting

http://www.consumerreports.org/doctors-hospitals/childbirth-what-to-reject-when-youre-expecting/

10 procedures to think twice about during your pregnancy

Despite a healthcare system that outspends those in the rest of the world, infants and mothers fare worse in the U.S. than in many other industrialized nations. Infants in this country are more than twice as likely to die before their first birthday as those in Japan and Finland. And America now ranks behind 59 other countries in preventing mothers from dying during childbirth and is one of only eight countries in the world, along with Afghanistan and El Salvador, whose maternal mortality rate is rising.

Why? Partly because mothers in the U.S. tend to be less healthy than in the past, “which contributes to a higher-risk pregnancy,” says Diane Ashton, M.D., deputy medical director of the March of Dimes.

But another key reason may be that medical expediency appears to be taking a priority over the best outcomes. The U.S. healthcare system has developed into a labor-and-delivery machine, often operating according to its own timetable rather than the less predictable schedule of mothers and babies. Keeping things chugging along are technological interventions that can be lifesaving in some situations but also interfere with healthy, natural processes and increase risk when used inappropriately.

(click link at the top to read on Consumerreports.org)

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THE BIG BABY CONUNDRUM

http://blog.everymothercounts.org/the-big-baby-conundrum/

When I read the January 11th New York Times Well blog, titled When A Big Baby Isn’t So Big, I looked back on my career as a labor nurse and thought, “Yep – happens all the time.” Predictions for a “too big baby” were among the most common reasons I heard from women admitted to my labor unit for induction of labor or scheduled cesarean sections. In most cases, once the baby was delivered, either vaginally or surgically, they weren’t all that big after all.

The New York Times blog is centered around a recent study based on Childbirth Connection’s national survey of 1,960 new mothers, called Listening to Mothers III. The survey indicates that four out of five mothers who were warned they might have large babies gave birth to infants who were not large, and weighed less than 8 pounds 13 ounces (which defines macrosomia – a larger than average baby). These mothers were almost twice as likely to have interventions like medical induction of labor or attempt to self-induce labor, presumably so their baby wouldn’t get too big to deliver vaginally. They were also nearly twice as likely to have planned C-sections, though as the blog mentions, researchers say that increase fell just short of being statistically meaningful.

(click link to read the blog on the Every Mother Counts website)