Mother not warned before infant death, inquest told

For further information, contact Melissa Maimann at Essential Birth Consulting.

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A coronial inquest is being held into whether a seven-hour-old baby who died of a streptococcal infection received appropriate care in a hospital in the south-east of South Australia.

… An autopsy revealed the baby died of problems associated with a group-B streptococcal infection.

Deputy state coroner … heard the mother … had a positive streptococcal test weeks before she went into labour, but had not been made aware of the result.

… The court heard Ms Linnell was not given antibiotics – the common practice for treating group-B streptococcal infection.

GBS testing is not routine through Australia, or even throughout the developed nations. It is tested by a vaginal swab, usually at 36 weeks, but can also be tested by urine test or rectal swab.

Women who are found to have GBS are advised to have antibiotics in labour to reduce the chance of the baby becoming affected. Very few babies born to mothers who have GBS are affacted but if they are affected they can become very sick very fast, as indicated in the story above.

I’m sure the woman in this story did not receive continuity of care from a midwife – if she ahd have received this gold standard care, no doubt the positive GBS result would not have been missed. But unfortuntely it’s easy to miss a test result when yours is one of many that your care provider is managing.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Tags: Babies, birth, Complicated pregnancy or birth, continuity of care, hospital birth, midwife, Midwifery, Midwifery, Midwifery services, Obstetrics, Public and private hospitals

Women Value Safety Over Choice

For further information, contact Melissa Maimann at Essential Birth Consulting.

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New research to be published in BJOG: An International Journal of Obstetrics and Gynaecology suggests that ‘choice’ may not be the best way to understand women’s decision-making about birth method. The results of the study question the current focus on choice in UK maternity care policy, and challenge prevailing notions about caesarean delivery for maternal request.

… Current guidelines highlight the role of women’s preferences in choosing between birth methods such as vaginal birth and caesarean section.

Caesarean delivery on maternal request (CDMR) is a subset of elective caesarean section, performed not by medical necessity, but on request of the pregnant woman. CDMR is perceived as a leading reason for increasing caesarean section rates.

In this study, researchers tracked 454 women at the Liverpool Women’s Foundation NHS Trust. The study aimed to explore the views and experiences of women … to identify how they report decision-making surrounding birth method. This is the first longitudinal study of women’s views of CDMR in the UK to follow the same cohort of women from their antenatal booking appointment to 12 months after birth.

The key findings indicate that while most women felt that vaginal birth might be preferable, they accepted that their actual birth method would be determined by the circumstances of their pregnancy, the position of the baby, the course of their labour, and the practices of midwives and obstetricians they encountered.

… By late pregnancy the proportion of women expressing a preference for CDMR had declined to 2%, while those reporting a preference for vaginal birth increased to 80% …

Moreover, women felt that health concerns should take precedence in decision-making and entrusted health professionals to act appropriately. Any personal preference, such as convenience, was viewed as secondary to maintaining the safety of the baby.

The study found that the percentage of women who expressed a preference for planned caesarean section was very low …

I have met very few women who request a CS. The vast majority of women want to have a natural vaginal birth with as little intervention as possible. The issue lies with our current maternity system that is, for the most part, obstetrically-driven and is based around CYA policies.

Most women will not know if their CS is truly necessary or not, just as I would not know if I really need a new ball joint or brake pads on my car. Maybe that’s why my car services always cost $1,000!! Jokes aside, should women pre-arm themselves with oodles of information before they have a hospital birth, just so they can avoid being one of the 35% women who have a CS? According to the study, our CS rate is not as high as it is because of women wanting a CS: only about 2% CSs are done because women want them. The other 33% have them because their care providers have recommended them, yet for at least 50% of these women, the CS was not necessary. So should women have to have a private midwife, read wide and far about birth and be prepared to fight for a positive birth experience in hospital? It would be nice if a woman could go to hospital with a birth plan and have the staff work with her to achieve her birth plan. Sadly this is not the case. For the time being, the best advice I can give a woman who is planning a natural birth in hospital, is to have a private midwife with her. Private midwives are obliged to ensure that the care provided by hospital staff is evidence-based and regarded as good practice. In the event that hospital staff do not provide care that is considered to be safe and necessary, your private midwife will challenge this on your behalf.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Tags: birth, Birth choices, Caesarean, hospital birth, intervention, midwife, Midwifery, Midwifery, Midwifery services, Obstetrics, Public and private hospitals, women's rights

No room at hospital for ‘high-risk’ pregnancies

For further information, contact Melissa Maimann at Essential Birth Consulting.

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PREGNANT women were being turned away from Bowral
Hospital because the maternity ward doesn’t treat high-risk pregnancies, a mother of six has claimed.

The News understands there is only one permanent obstetrician currently on staff after two had left during the past six months.

Several women claim they were told they couldn’t deliver at Bowral because they were considered high-risk and not because of inadequate resources.

… the hospital no longer delivers babies for women who have had caesareans.

Mother of six Kellie Bennett said she was forced to have her first home birth in February after her obstetrician … left the hospital late last year.

… A GP told Mrs Bennett a few days later she couldn’t deliver her baby at Bowral because the hospital had a no-vaginal birth after caesarean policy.

She was told she would have to attend Campbelltown Hospital, but should be prepared to travel to Liverpool Hospital as Campbelltown had issues with their own numbers and may not be able to accommodate her.

Mrs Bennett’s fifth child was delivered via caesarean in July 2007 with no complications.

Worried about where she would deliver her most recent child, Mrs Bennett arranged to meet Bowral’s temporary obstetrician at the time … to discuss a plan of action … She was unsatisfied with the response.

That was the last time Mrs Bennett attended Bowral Hospital.

Bowral Hospital general manager Denis Thomas denied there was a policy of rejecting women with previous caesareans.

… He said Bowral was not equipped to deal with high-risk pregnancies and only catered for women with low risk and selected moderate risk pregnancies.

After obtaining her medical records before her home birth Mrs Bennett said she discovered abnormalities in her previous pregnancies.

She said her fourth child was delivered by caesarean because she was told it was in a difficult breech position but her records show the baby was in normal breech position for a natural birth.

…She added she was told she was at high-risk because of high blood pressure, but her records didn’t indicate that.

“I was upset at the time as I assumed they knew best,” she said. “Maybe women who are told they are at high-risk aren’t at high-risk at all.”

The Colo Vale resident wondered if women were being unnecessary induced and given caesarean births because of the lack of resources at the maternity ward.

…. The birth of her sixth child Matilda on February 27 went perfectly and she recommended home births to other expectant mothers.

… Mrs Bennett said more information on home births needed to be available to mothers if the hospital was unable to look after them.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Tags: birth, Birth choices, Birth trauma, Caesarean, Complicated pregnancy or birth, continuity of care, Home birth, hospital birth, intervention, midwife, Midwifery, Midwifery, Midwifery services, Normal Birth, Obstetrics, Public and private hospitals, VBAC, women's rights

Study Identifies Correlation Between Sex Ratios At Birth and Latitude

For further information, contact Melissa Maimann at Essential Birth Consulting.

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Although researchres have known for decades that more boys than girls are born throughout the world, a new study published … shows that the closer a population lives to the equator, the smaller the difference becomes …

… there was a significant correlation between sex ratios that were skewed toward boys and climate variables related to latitude. African countries had the lowest sex ratios, with 50.7% of births being boys, while European and Asian countries had the highest, with 51.4% of births being boys. According to the study, the effect of latitude was present across wide variations in lifestyle and socioeconomic status, with large differences in sex ratios between tropical regions closer to the equator and temperate regions farther from the equator …

… One explanation could be that there is a survival value in producing more girls in warmer regions … Other theories include the quality of sperm at different temperatures causing variations, or “some event during gestation at warmer temperatures that causes more male fetuses, or fewer female fetuses, to spontaneously abort,” …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Tags: Babies

Breastfeeding reduces the risk of Heart Attacks Or Strokes

For further information, contact Melissa Maimann at Essential Birth Consulting.

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The longer women breastfeed, the lower their risk of heart attacks, strokes and cardiovascular disease … We have known for years that breastfeeding is important for babies’ health; we now know that it is important for mothers’ health as well …

According to the study, postmenopausal women who breastfed for at least one month had lower rates of diabetes, high blood pressure and high cholesterol, all known to cause heart disease. Women who had breastfed their babies for more than a year were 10 percent less likely to have had a heart attack, stroke, or developed heart disease than women who had never breastfed.

Dr. Schwarz and colleagues found that the benefits from breastfeeding were long-term – an average of 35 years had passed since women enrolled in the study had last breastfed an infant …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Tags: Babies, Breastfeeding

Midwifery around the world

For further information, contact Melissa Maimann at Essential Birth Consulting.

We may think we have it bad here …..

Bulgaria

Here in Bulgaria, we do not have the same rights as elsewhere around the world. I mean the right of “self-practice.” For a long while the government has avoided passing laws that allow this. Only the doctors are allowed to look after a pregnant woman, take care of her and assist in delivery. The basic college education required for midwifery is at a high level, but the job is not so interesting because we cannot have our own business in the terms of self-practice. Midwifery is unbelievably poorly paid, which is also one of the main reasons that young people are not interested in the profession. There also are not enough opportunities for further education and advancement.

Methods like Bradley, HypnoBirthing, Lamaze, Perinatal Psychology and others are unknown here. This situation harms pregnant women. Parturition is allowed only in hospitals and the women go there knowing nothing and, most of all, with fear.

— Tony Kalushkova
Veliko Tarnovo, Bulgaria

United Arab Emirates

In the United Arab Emirates we are working on the following projects: 1. Decreasing episiotomy (indication: fetal distress-shoulder dystocia) by letting delivery occur without episiotomy, with normal tears; 2. Skin to skin contact immediately at the birth and in a baby-friendly hospital; 3. Side position delivery for any patient who desires; and 4. Cleaning baby with oil instead of water.

— Leila Mostofi
United Arab Emirates

Quebec

I am heading tomorrow to work in Puvirnituq for a month, an amazing community among the Inuit of Northern Quebec, where birth has been taken back by the community in spite of the full-scale evacuation of all women from there in the late ’70s and early ’80s by the Federal Medical Services Bureau. This community provides the hope of what a small community can do when the women take power and kick the white male dominant culture out on a snow drift.

Almost all of Northern Quebec has now been rematriated, and almost all birth now takes place back in the community again, with better outcomes, even though they are a two- to eight-hour plane ride to cesarean section facilities. This was the work of 20 years of Inuit determination and help from southern white midwives, while US communities seem to have gone the opposite direction in the same time period. While the Inuit hadn’t even heard of any “Yes, We Can” slogan, it was a case of cultural survival. That is what we need to transmit to women and communities at large. How birth is handled in any society is a barometer of that culture’s survival capacity.

— Betty-Anne Daviss

Melissa Maimann, Essential Birth Consulting 0400 418 448

Tags: birth, hospital birth, intervention, Obstetrics, women's rights

Evidence Increases for Risks in Cesarean

For further information, contact Melissa Maimann at Essential Birth Consulting.

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As research continues to mount for the risks of cesarean surgery, the Centers for Disease Control released new, staggering statistics reporting that 31.8% of women endure birth by cesarean in the United States (2007). This announcement comes after the release of significant findings from the New England Journal of Medicine reinforcing that birth by cesarean surgery before 39 weeks of pregnancy causes increased complications in newborns.

This is no different to Australia’s CS rate.

Despite the latest advances in medical technology, health care providers cannot determine a baby’s due date with 100% accuracy. Therefore, cesarean surgeries scheduled before a woman’s estimated due date could result in a baby born as early as 36 weeks to a few days before the baby is actually due. During the last few weeks of pregnancy, a baby’s lungs mature and a protective layer of fat forms, both of which are vital developments for a healthy baby. In addition, babies need time for their lung cells to shift from being fluid producing to fluid absorbing cells. Without time during labor to prepare the baby to breathe, lungs cells may not be ready. Thus, babies born by cesarean surgery, even when they are full-term, need to go to an intensive care unit more frequently than babies who were born vaginally to get help breathing.

Research published in the New England Journal of Medicine (NEJM) supports earlier findings that cesarean surgery performed prior to 39 weeks of pregnancy increases poor outcomes in babies. Of the babies … born before 39 weeks, more than 26% had complications, including the need to be on a ventilator, respiratory distress syndrome, low blood sugar and severe infection …

“Overuse of cesarean surgery complicates the otherwise natural process of birth,” says Lamaze Institute Chair Debra Bingham, LCCE, MS, RN, DrPH, “Allowing the natural process to occur not only reduces risks for mothers in this and future pregnancies, but also reduces health risks for her baby.”

Spontaneous labor is almost always the best indication for a baby’s physical readiness for life outside of the womb … Allowing labor to begin naturally increases the likelihood that a baby is healthy and ready for birth. When a birth outcome is good, mother and baby can bond and start breastfeeding immediately after birth—both of which provide the best start for a baby’s growth and development.

… The most commonly used practices [in American (and Australian) birth] don’t align with the best evidence for a healthy birth …

Cesarean surgery—a major abdominal surgery—also carries risks for women, such as blood loss, clotting, infection and severe pain, and poses future risks, such as infertility and complications during future pregnancies such as stillbirth and placenta problems like percreta and accreta, which can lead to excessive bleeding, bladder injury, hysterectomy and maternal death. The research is clear, however, that when medically necessary, cesarean surgery can be a lifesaving procedure for both mother and baby, and worth the risks involved.

Two of the most important decisions a woman can make are where she gives birth and who she chooses as her care provider.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Tags: birth, Birth choices, Caesarean, Complicated pregnancy or birth, continuity of care, Home birth, hospital birth, intervention, midwife, Midwifery, Midwifery, Midwifery services, Normal Birth, Obstetrics, Public and private hospitals, women's rights

Upright Labor Positions Reduce Pain and Speed Birth

For further information, contact Melissa Maimann at Essential Birth Consulting.

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Women who walk, sit, kneel or otherwise avoid lying in bed during early labor can shorten the first stage of labor by about an hour, according to a new Cochrane evidence review. Women who labored out of bed during the early stages were also 17 percent less likely to seek pain relief through epidural analgesia, the review found.

… So why would staying out of bed shorten labor and reduce pain?

… “The ability to change positions, to utilize a wider variety of positions, and try other options, such as hot showers, birthing balls and beanbag supports, may help reduce overall pain and give women a greater sense of control over the progress of their labor”.

When women are upright, there is also more room for the baby to move downward because the diameter of the pelvis expands slightly. This puts less pressure on nerves in the spine, which could mean less pain.

… Being upright allows gravity to help the baby make her way into the world. Lawrence said, “The physiological advantages of upright positions and mobility include the effective use of gravity, which aids in the descent of the baby’s head. As the head is applied more directly and evenly against the cervix, the regularity, frequency, strength and therefore efficiency of uterine contractions are intensified.”

When the mom-to-be moves, this also helps the baby to get into the best position to hasten birth. “This improves its alignment for passage through the pelvis,” Lawrence said. “There is also a psychological advantage associated with the belief that being upright and mobile empowers women to actively participate in their birth experience and maintain a sense of control.”

Other research has found that feeling in control and able to make choices reduces pain and psychological distress in general.

In contrast, however, lying flat on one’s back during labor can put a great deal of pressure on the blood vessels in the abdomen. “There is widely accepted physiological evidence that the supine position may be harmful in late pregnancy and labor,” Lawrence said.

According to the reviewers, the supine position puts the entire weight of the pregnant uterus on the blood vessels that supply oxygen to both mother and child, which could potentially lead to problems with heart functioning in the mother and reduced oxygen to the baby. These outcomes could be serious in extreme cases. Lying on one’s side has no link with such problems, however.

Stone-Godena said that despite all the attention given to empowering women to have the type of birth experience they prefer, medical professionals still pressure women into lying in bed during labor, because it is more convenient this way for nurses and doctors and makes fetal monitoring easier.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Tags: birth, Complicated pregnancy or birth, fetal monitoring, hospital birth, intervention, Normal Birth, Obstetrics, Public and private hospitals

when it comes to childbirth, there’s no place like home

For further information, contact Melissa Maimann at Essential Birth Consulting.

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… My wife chose to have her babies with a midwife, who was with her throughout the entire journey – from when those first few cells were dividing to the time the baby had gained a few pounds to compulsory breastfeeding. She also chose to not to go into hospital, a place dominated by inner and outer males whose protocols dictate the procedure in the business of birth. All birthing animals like to be born – and die, incidentally – in familiar, dark and gentle places.

I might have been more in line with my species by saying: “If the doctors say you have got to have a C-section because the baby is breech then they must be right because they’re doctors. This is the 21st century; they can take away the pain so you don’t have to suffer. What counts is the baby’s life and yours. There’s no need to act like a spoilt, complacent woman.”

… The excitement of being at home for me meant that I had no choice but to be in the thick of it. The sheer joy of looking at your child’s features and recognising your own in them, to be allowed to hold your seconds-old newborn and place her on your partner’s chest. For your tears of ecstasy to drip on to your first son (after three daughters) as you repeat, mantra-like: “It’s a boy, it’s a boy, it’s a boy.” I even commented on the minor repairs of a small tear on the perineum – none of these intimacies could happen unless you are in your own space.

My mother, who was also present at one of our children’s births, had a profound experience. She, like me, could remember nothing of our difficult forceps delivery; her fear of birth was expunged. The trail of little feet, who always time their entrance after the event, somehow sleeping through the raised night-time noise levels, pile in to prod, kiss and fondle their new sibling. It’s a party atmosphere and everyone is invited.

It doesn’t happen like that in the wing of your average hospital. My wife’s future, and consequently mine, was born by the nature of our children’s arrival: two breech and two cephalic (with head down, the most usual birthing position). The experience precipitated the choice of a new career for her as an independent midwife.

… The pragmatic truth about the hospital birthing industry is that we don’t quite trust it to provide a proper and responsible service. It is not its fault that midwives and doctors work in dysfunctional institutions that sometimes make mistakes and misjudgments that affect us. It is not intentional. We try to choose the best hospital as we try to choose the right school, but sometimes it doesn’t work out. The problem with hospitals is that they like routine and babies don’t always fit into their schedule. Just check the Caesarean rate on a Friday. On the other hand what a fantastic facility to have available when there is a real problem such as pre-eclampsia or placenta praevia, and they are there to intervene and save a life. The problem is that they want to intervene in normal birth too – with epidurals, inductions, the effect of opiate drugs and inappropriate communication that can lead to poor outcomes.

Reid claims that homebirth is a minority sport. Not true. Where homebirth is available with one-to-one care the statistics shoot up. In Torbay, in Devon, it’s 11 per cent …

The real issue is not whether you have your baby at home or in a hospital, it is how you have your baby. It is “continuity of care” that is the key – a trained midwife who is with a woman from start to finish and a little beyond. It is a holistic approach because how you think and feel about it affects your confidence to give birth and function as a future parent. If you can achieve that in hospital then fine; if not, you should be able to consider alternatives.

This is where men can make a difference. You may think your role is insignificant and all you are doing is protecting your partner and unborn child by making sure they get the right treatment. Well, treatment is usually for illness and for most normal births it is not required. What is required from men is that they trust their partner’s instincts and understand emotionally what is occurring … if you don’t like what you hear get a second opinion. Take responsibility and stop colluding with other males with the mindset of taking control.

I think I was brave to side with my wife’s instincts when she became “high risk” because the baby was breech. “You don’t want a dead baby” was the advice I got from everyone. I knew that what I said to my wife would have a huge impact on what we did. I know most males would not take that route, fearing that the blame of giving the wrong signals would fall on them if it all went wrong. But that’s what responsibility is: making choices with your heart and mind and living with the consequences.

As you get older, increasingly, your heart rules your head. When I think back to the moment my grown children entered the world just feet from where I’m sitting yet more tears drip into my keyboard. I think about how those first few moments together has affected everything that has happened since.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Tags: Babies, birth, Birth choices, continuity of care, Home birth, hospital birth, intervention, midwife, Midwifery, Midwifery, Midwifery services, Normal Birth, women's rights

C-Section Raises Risk of Asthma in Newborns by 79 Percent

For further information, contact Melissa Maimann at Essential Birth Consulting.

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NaturalNews) Children delivered by cesarean section (CS) are significantly more likely to develop asthma and allergies later in life than children delivered through vaginal birth …

… CS is becoming more common as many women’s preferred method of childbirth. Researchers compared the rates of asthma and allergies among 2,917 eight-year-olds, comparing the rates between those who had been delivered vaginally and those who had been delivered by CS. They found that the risk of asthma was 79 percent higher in those delivered by CS compared with those delivered vaginally. The correlation between c-section and asthma risk was even higher among children born to one or more parents with allergies.

…. C-section is already known to raise a child’s risk of diabetes by 20 percent, compared with vaginal delivery. In spite of this known health risk, rates of the procedure have been steadily rising in the United States over the last 25 years, increasing by 46 percent since 1985 to a current level of more than 30 percent of all births.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Tags: Babies, Caesarean, Complicated pregnancy or birth, intervention, Obstetrics, Public and private hospitals