Tag Archives: Babies

Coroner warns on babies in bed

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A CORONER has delivered a damning judgment against the practice of parents sleeping with their infant children.

He concluded that it increased the risk of the child dying.

South Australian Coroner Mark Johns made the ruling after holding an inquest into the deaths of five babies in 2007 and 2008 who had slept with a parent or grandparent.

“The message to be drawn from these five tragic deaths is that the risk of sudden, unexplained death in infancy is greatly increased where a child sleeps in the same bed with one or more parents or other adults, whether the mechanism of death is asphyxia due to overlaying, bedding or otherwise,” Mr Johns said in his findings.

Seven-week-old Hannah Francis died after her father, who was trying to settle her, lay on the couch with her on his chest. It was about 3am and the tired father fell asleep. When he woke up about six hours later he found his baby suffocated, lying between a pillow and the back of the couch.

Naomi Kade was 10 months old when her grandmother joined her in bed to sleep. At some point in the night the grandmother’s arm came to cover Naomi’s nose and mouth, leading to asphyxiation.

James Cleland, four months, went to sleep with his mother and a four-year-old sibling with his head between two pillows. He was found lying slightly on his left, facing into a pillow.

Diesel Phelan, three months, and Jaia Nelson, three weeks, had been sleeping with their mothers when they died.

South Australian SIDS and Kids state manager Colin Cameron said his group had been advocating for 20 years against parents sleeping with their babies.

“We recommend that parents do not co-sleep at all,” Mr Cameron said. “Infants are very vulnerable in those first 12 months.”

… although co-sleeping increased risks of sudden death in babies, there were some benefits to parents sharing a room with an infant where the child slept in a cot.

… infants sleeping in the same room as their parents were more stimulated and therefore would not experience deep sleep, which cut the risk of Sudden Infant Death Syndrome.

Mr Johns said placing an infant in a cot beside the parental bed seemed reasonable …

Professor Byard noted co-sleeping was common in some societies and cultures that had not experienced problems with infant deaths.

But in Western society the situation was different because bedding tended to be softer than some traditional Asian societies and parents tended to be heavily built and often affected by alcohol or other drugs …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Midwife the mother of invention of baby protection bracelet

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A SUNSHINE Coast midwife has become the mother of invention by developing a world-first wristband barcode system that safeguards babies from identification and feeding mix-ups.

Mrs Oglesby … invented Babywatch: an identification, tracking and monitoring system where [midwives] use a hand-held scanner to match mothers to babies.

Last year The Courier-Mail revealed babies were regularly being wrongly tagged in the state’s hospitals, with 57 identification errors reported over a 12-month period, with the number of reported mistakes doubling in three years.

“With today’s technology, it was just silly to keep going the way we always have,” Mrs Oglesby said.

“I knew there had to be a better management system.”

And there is a better management system: keeping mothers and babies together, unseparated. Or better still, birthing at home where you are never separated from your baby.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Why Home Births Are Worth Considering

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A new analysis … comparing home births and hospital births … not only presents misleading conclusions, it drives a wedge between two groups that cannot afford a greater divide: medical doctors and midwives.

The study documents similar perinatal … mortality rates for home and hospital births, but claims a three-fold increase in neonatal … mortality for home deliveries. Yet this analysis contains serious limitations and concerns those of us who practice midwifery in an out-of-hospital setting.

Beyond the issue of the flawed methodology, which has been addressed by several national organizations … there are serious cultural implications to this study.

As a medical anthropologist, I am concerned with the chasm with doctors and the medical establishment on one side, and midwives and the home birth movement on the other. In Oregon, where we have both licensed and unlicensed midwives working in home and in birth center settings, research has shown deep mistrust between doctors and some midwives. Many doctors have expressed the belief that only hospital births are safe, while midwives say they often feel marginalized and disrespected.

Such studies only deepen this mistrust and have the potential to increase hostility during encounters when midwives and their clients have to seek hospital care for complications. The end result is a system that can be detrimental to women and their babies because of the impaired ability to communicate across a cultural divide. Instead of a maternity system based on fear and misinformation, we need a system based on collaboration and mutual respect.

The United States is already the butt of jokes in the international public health community. We spend more on health care than any other high-income nation, while simultaneously serving the lowest percentage of pregnant women, as several of our key health indicators continue to decline each year … the U.S. now has the highest number of maternal deaths relative to all other high-income nations, and we also rank second worst for perinatal deaths.

The U.S. has not reported a significant decrease in maternal mortality rates since 1982, and the Center for Health Statistics indicates that the rate of cesarean section in this country is now at a whopping 32 percent, marking the 11th consecutive year of increase. As the incidence of cesarean section rates rise, so do medical complications for mothers and babies, along with associated health care costs …

The answer among the U.S. medical establishment has been to throw more expensive technology at the problem rather than retracing our steps to see where we went wrong. Instead of admitting that something is fundamentally broken with the system, organizations like the American College of Obstetrics and Gynecology continue to endorse the idea that medicalized hospital births are the only safe route for women.

We know that 99 percent of women in the U.S. are giving birth in hospitals, yet the United States has one of the highest infant mortality rates of any developed country … Meanwhile, the Netherlands, where one-third of deliveries occur in the home with the assistance of midwives, has a lower rate of 4.73 deaths per 1,000.

… other nations … have superior maternal and infant health outcomes, … and rely more extensively on cost-effective midwives as a public health strategy.

… homebirth midwives charge $2,000 to $4,000 — a fee that includes care from conception through the postpartum period. Exploring the option of home and birth center birth with midwives for low-risk women should be at the core of national health care reform and research. Instead, several generations of high-tech, low-touch birth and a pervasive cultural belief that birth is imminently dangerous — even in healthy, low-risk women — has led to powerful cultural blinders that limit options for women.

In anthropology, we say that “normal is simply what you are used to.” The power of socialization and the dominance of biomedicine have kept us from systematically examining a variety of birthing environments and providers as viable alternatives to the expensive and interventive hospital delivery that has become the norm in the U.S.

… [the] study found no difference between home births and hospital births when measuring perinatal death, which is the primary indicator for evaluating the safety of a mode of delivery. Yet, the study chose instead to focus on neonatal death, generally accepted as death within the first 28 days of birth and to emphasize this part of their research. A complex mix of psychosocial and clinical factors, including congenital anomalies, Sudden Infant Death Syndrome, unsafe home environments, and poverty, can all contribute to death in the first month of life … after removing low-quality studies and out-of-date statistics, the Wax study actually demonstrates no difference in outcomes between home and hospital-based delivery, even for neonatal mortality.

Yet the authors included faulty data in their total analysis, comparing apples to oranges by mixing different types of data sets, such as grouping low-risk with high-risk mothers, and including babies born unintentionally at home.

… There is something to be learned from the centuries-old traditions of midwifery, and I believe that if doctors and midwives, including those who work in the home setting, could be willing to learn from and respect one another, women and babies in our country would benefit. After all, we are all working for the same end result: a happy and healthy mother and baby. Our differing visions of how to get there will require an attitude of cultural humility and a willingness to listen. Studies like the Wax study take us in the wrong direction.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Mum nurses baby back to life

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AN Australian mum has made headlines worldwide after cuddling her tiny baby back to life.
The grieving mother had given up hope of saving newborn Jamie, after doctors pronounced the tiny boy dead.

While Jamie’s twin sister, Emily, was delivered safely, doctors worked for about 20 minutes to get premature Jamie to breathe before declaring that he couldn’t be saved.

… “I unwrapped Jamie from his blanket. He was very limp. I took my gown off and arranged him on my chest with his head over my arm and just held him. He wasn’t moving at all and we just started talking to him.”

Ms Oggs said she and her husband, David, had given up saving Jamie, who was born at 27 weeks and weighed less than 1kg.

… after about two hours of being hugged, touched and spoken to, little Jamie miraculously showed signs of life.

“Jamie occasionally gasped for air, which doctors said was a reflex action,” Ms Oggs said.

“But then I felt him move as if he were startled, then he started gasping more and more regularly.

“I gave Jamie some breast milk on my finger, he took it and started regular breathing.”

… “A short time later he opened his eyes. It was a miracle,” Ms Oggs said.

“Then he held out his hand and grabbed my finger.

“He opened his eyes and moved his head from side to side. The doctor kept shaking his head, saying, ‘I don’t believe it’.”

The Sydney mum spoke publicly to highlight the importance of skin-on-skin care for sick babies.

The technique, known as kangaroo care, is often used in neo-natal wards and is thought to promote a more stable temperature, better breathing and weight gain …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Home births in Wales double over decade

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I live for the day that we have these headlines here in Australia!

The number of women who give birth to their children at home in Wales has more than doubled in less than a decade …

Since 2002 … they have risen from 604 to approximately 1,395 last year.

There has also been a rise in women giving birth in midwife-led units.

… the assembly government has encouraged healthy women with low-risk pregnancies to have their babies out of hospitals.

In 2002, maternity services in Wales were asked to reach a 10% home birth rate by 2007, making it the only nation in the UK to have a target.

Midwives say that while it was a very ambitious aim and many areas have not managed to reach it, it has helped transform the choice in maternity services.

On average, 4% of births in Wales last year were at home, which is higher than the UK average of 3%.

Laura Williams gave birth to her daughter Megan at home in Porthcawl, Bridgend county, on 5 November, 2009.

… “I wanted to be in a more comfortable environment – I liked the fact that with a home birth I could use my own shower and sit on my own sofa.

“As it was, I had a fantastic birth at home. I borrowed a friend’s pool and was really relaxed. The midwife even cleared everything up afterwards – I saw no mess.

… “I also think the fact I was at home and relaxed helped my recovery from the birth – the next day I was up and about and even popped to the shops.”

… “Midwives are continuing to work towards it because many see the benefits home births bring.

“They are cost effective in that women don’t need to stay in hospitals.

“And for the mother, there is less risk of medical intervention, the birth is well planned, she is in a relaxed environment and often doesn’t have to leave other children.”

… Rather than staffing a large obstetric unit at a hospital, which midwives have to do in more populated areas, they can “focus on staffing women’s needs”, she said.

… The issue of home births has been in the headlines recently after medical journal The Lancet said mothers-to-be should not be able to opt for them if they put their babies at risk. Under UK law women can override medical advice.

It came after research published in the American Journal of Obstetrics and Gynaecology suggested home births were more risky than hospital delivery.

But the Royal College of Midwives said the research was “flawed”, and the assembly government insisted that only women with low-risk pregnancies were encouraged to have their children at home.

The chief nursing officer for Wales, Rosemary Kennedy, said: “It is for midwives and other health professionals to explain to pregnant women the birthing options available to them, and decide on the most appropriate option after considering their medical history and preferences.”…

Melissa Maimann, Essential Birth Consulting 0400 418 448

New unit a ‘home birth in hospital’

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MONA Vale Hospital’s new birthing unit will simply be a place for expectant mothers to have a home birth inside a hospital – but a long way from emergency care if a complication occurs – according to an obstetrician.

How anyone can consider a hospital birth to be the same as a homebirth is way beyond me! There is a very big difference between the comfort and familiarity of our homes, and a hospital environment.

Dr David Jollow, one of Mona Vale Hospital’s onsite obstetricians, said the new, midwife-run, Mona Vale birthing unit would mean women who suffer a complication during labour will have to be rushed to Manly Hospital instead of being treated by Mona Vale’s onsite obstetricians.

“The new unit is essentially a home birth that happens to be in a hospital,” Dr Jollow said.

“It would actually be safer to have a home birth in Balgowlah or Seaforth, because an ambulance ride to Manly would be quicker.”

It’s interesting that obstetricians oppose free-standing birth centres, yet we have the existence of midwife-run units where obstetricians are not available. Is ther a differnence? Is it merely a differing terminology to be acceptable to some?

Melissa Maimann, Essential Birth Consulting 0400 418 448

Woman reportedly pregnant for nearly two years

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Unbelievable!

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Chien’s husband, Duong Van Tuan .. .claimed that his wife has been pregnant for 21 months. He explained that his wife saw doctors the first time when she was over three months pregnant.

Doctors examined her and made an ultrasound scan, saying the child was a boy and very healthy. They calculated that she would give birth in early September 2009.

The woman had no labor pain on the days that doctors anticipated … doctors examined her again and told the family they must wait because Chien has not begun labor yet. The placenta clung to the womb, so they couldn’t perform an operation, which could cause hemorrhaging.

For two months afterwards, Chien still have no sign of labor pain though she still felt the child move. When she was 11 months pregnant, the couple went to the Central Obstetrics Hospital in Hanoi and doctors still said that they must wait.

“I have been waiting for my wife’s labor for nearly one year. But I can’t wait anymore because the fetus is 21 months old already. Doctors at the Central Obstetrics Hospital made an appointment for us on August 20 to decide on an operation …

Dr. Tran Danh Cuong, chief of the Central Obstetrics Hospital’s Obstetrics 1 Ward, said this is a very weird case. He stated that no child can live for over 45 weeks in the womb. “No doctor should let a woman be pregnant for 21 months,” Cuong confirmed.

Correction: some babies can live beyond 45 weeks. It is unheard of in today’s times because most babies are induced even before 42 weeks (which is still considered normal pregnancy). In our grandparent’s generation and prior, some babies did indeed remain inside until well beyond 42 weeks and survive.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Home birth—proceed with caution

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The increased demand to give birth outside hospital has increased the rate of home delivery. In the Netherlands, a third of women now have home births. In the UK, 3% of total births occur at home, while in the USA home delivery accounts for 1% of births or 25 000 deliveries per year.

In Australia, 0.6% babies are born at home. This rate has increased in past years.

Home birth rates have been increasing in the USA partly because of the increasing proportion of births by caesarean delivery … because doctors and hospitals opt not to do a vaginal birth after a caesarean to avoid liability lawsuits …

Although home birth seems to be safe for low-risk mothers and, when compared with hospital delivery, is associated with a shorter recovery time and fewer lacerations, post-partum haemorrhages, retained placentae and infections, the evidence is contradictory for outcomes of newborn babies delivered at home … The problem arises when planned home births become hospital births when complications arise, and this can then lead to an underestimation of the risk and overestimation of the benefit of home births. Data from the Netherlands, for example, suggest that up to 40% of nulliparous women who start labour at home are transferred to the hospital. Most studies also rely on different midwifery models for home delivery, which are not generalisable.

Professional organisations … have issued contradictory policy statements regarding home deliveries. The Department of Health of South Australia has a detailed policy for home birth among women with low-risk, singleton term pregnancies, while the UK’s Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives jointly support home birth in women with uncomplicated pregnancies. By contrast, ACOG does not support home birth, citing safety concerns and the lack of rigorous scientific evidence. Choosing to deliver a baby at home, states ACOG, is to show preference for the process of giving birth over the goal of having a healthy baby.

A recent meta-analysis … provides the strongest evidence so far that home birth can, after all, be harmful to newborn babies. The research incorporated 12 studies and 500 000 births from several industrialised nations … The data show that planned home births to healthy and low-risk mothers compared with planned hospital births in the same group of women doubled the risk of neonatal deaths (0·2% vs 0·09%). And when infants with congenital defects were excluded, the risk of neonatal mortality tripled. The main attributable factors for the increase in mortality were the occurrence of breathing difficulties and failed attempts at resuscitation—two factors associated with poor midwife training and a lack of access to hospital equipment. In the USA, for example, only a third of home births are accompanied by a certified midwife.

Analysing the outcomes of these studies, what we can learn from this meta-analysis is that homebirth is safe for low risk, healthy women, whereas high risk homebirth translates to mroe complications for mothers and babies.

Women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk. There are competing interests that need to be weighed carefully. Hospital delivery should be the preferred method of delivery for high-risk pregnancies … Home delivery is an option for mothers with uncomplicated pregnancies, provided they are advised of the risks involved, have one-to-one midwife care (that includes good resuscitation skills and accreditation by a local regulatory body), and live in a location that allows quick access to obstetric care.

The situation in Australia is that fetuses do not have any rights until they’re born and breathing, therefore, the woman’s preferences are supported in pregnancy. An ethical stance would hold that the duty of care to the fetus increases as it reaches term.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Comprehensive support for pregnancy, birth and baby just a phone call away

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The Federal Government is providing more support for Australian women and their families with a new, expanded national 24 hour Pregnancy, Birth and Baby Helpline commencing on 1 July 2010. Women, their partners and families will be able to call the Helpline on 1800 88 24 36 for advice and information about pregnancy, birth and the first 12 months of a baby’s life. The independent charitable organisation, Royal District Nursing Service Ltd, will provide this free service, offering information and counselling on a wide spectrum of topics relating to pregnancy, birthing and life with a new baby – including issues such as nutrition for mothers and babies, breastfeeding, relationship support and health care options.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Midwifery care? An Uncertain Future.

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Houston, we have a problem.

At July 1, 2010 eligible midwives must work in a collaborative agreement with an obstetrician. This agreement must be signed by the obstetrician. It legitimises obstetric control over women’s choices. Even basic choices such as limited (or no) vaginal examinations in labour, refusal of continuous monitoring in women who are planning a VBAC, delayed (or no) induction and so on. Of course, it also depends on how reasonable the obstetrician is.

You see, in order for an eligible midwife to be insured for her practice, she must work collaboratively with an obstetrician and this is evidenced by a signed collaborative agreement. No signed agreement = no collaboration = insurance will not respond to any claims and therefore the midwife is working uninsured (and therefore outside the conditions of her registration) and may be de-registered.

Once in the collaborative agreement, the midwife, woman and obstetrician must reach agreement about the plan of care if the woman’s condition is classed as a B or C in the ACM Guidelines.

What sorts of conditions are listed as B in the Guidelines?

Previous post-partum haemorrhage
Hypothyroidism
Weight over 100kg
History of mental health disorders
Mild asthma
IVF pregnancy
Previous forceps or vacuum delivery
Having baby number 5 or more
Previous shoulder dystocia
VBAC
Long labour (<1cm/hr progress)
And the list goes on. These women must have a consultation with an obstetrician and the ongoing plan of care must be agreed by the woman, midwife and obstetrician.

What sorts of conditions are listed as C in the Guidelines?

Type 1 diabetes
Coagulation disorders
Lupus
Twins
Pre-eclampsia
Breech in labour
Gestational diabetes requiring insulin
Prem labour
And so on. These women cannot be cared for by a midwife; their care must be transferred to an obstetrician. The midwife’s continued involvement in the woman’s care must be agreed by the obstetrician. Even though the woman engaged the service of the midwife, has a contract of care with the midwife and has paid her midwife.

There is no right of refusal. The midwife will consult with an obstetrician on the woman’s behalf if the woman refuses to consult in person. If the obstetrician does not agree to the plan of care – the midwife cannot continue care of the woman because the woman’s condition is considered outside the scope of the midwife’s practice (and therefore outside of insurance and registration).

This system of collaboration is in place in other countries such as The Netherlands, NZ and Canada. The difference in those countries is the professional respect and standing of midwives that enables them to act as autonomous care providers to their women. Have you read The Birth Wars? Read it – it’s an eye opener and provides great insight into the current maternity system. Nicole Roxon wants obstetricians and midwives to work together. It seems she’s thrown us all into the bucket and simply said, “make it work!”. Unfortunately, entrenched attitudes and beliefs do not change quickly.

Collaboration will work when:
Collaborative agreements are negotiated at College level, not local level.
Obstetricians are mandated to require with collaborative agreements. At present they can refuse to sign a collaborative agreement.
Midwives have an avenue for appeal if they – or their clients – are treated unfairly.
Visiting rights are in place.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Risk for babies born one week early: Serious health problems more likely

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Babies born only a week early are at higher risk of a host of serious health problems from autism to deafness …

A study of hundreds of thousands of British schoolchildren found that those born at 39 weeks are more likely to need extra help in the classroom than those delivered after a full 40 weeks in the womb.

… With most planned caesareans carried out at 39 weeks, the finding raises concerns that women who have the operation for non-medical reasons could unwittingly be endangering the health and prospects of their children.

… Almost 18,000 had been classed as having special educational needs. The term covers learning disabilities such as attention deficit hyperactivity disorder, autism and dyslexia, and physical problems such as deafness and poor vision.

The risk was highest in those who spent the shortest time in the womb. For instance, babies born at between 24 and 27 weeks were almost seven times more likely to need help at school than those delivered at 40 weeks. But even being born just a few weeks early made a difference …

Those born at 37 weeks were 36 per cent more likely to have learning difficulties, while for those born at 38 weeks the figure stood at 19 per cent.

Babies born at 39 weeks … were 9 per cent more likely to have special needs …

… These findings … suggest that deliveries should ideally wait until 40 weeks of gestation … ‘However the cause of early birth may contribute to the risk, for example, a baby who’s already sick may need to be delivered early to give it a chance of survival …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Should I go private to have my baby? The care is better in the private system, isn’t it?

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Well, maybe not. The study below compared postnatal care in the public and private system. Read on to find out more.

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Concerns have been raised in Australia and internationally regarding the quality and effectiveness of hospital postnatal care …

A statewide review of public hospital postnatal care in Victoria from the perspective of care providers found many barriers to care provision including the busyness of postnatal wards, inadequate staffing and priority being given to other episodes of care; however the study did not include private hospitals. The aim of this study was replicate the review in the private sector, to explore the structure and organisation of postnatal care in private hospitals and identify those aspects of care potentially impacting on women’s experiences and maternal and infant care.

This provides a more complete overview of the organisational structures and processes in postnatal care in all Victorian hospitals from the perspective of care providers.

… Private hospital care providers report that postnatal care is provided in very busy environments, and that meeting the aims of postnatal care (breastfeeding support, education of parents and facilitating rest and recovery for women following birth) was difficult in the context of increased acuity of postnatal care; prioritising of other areas over postnatal care; high midwife-to-woman ratios; and the number and frequency of visitors. These findings were similar to the public review.

Organisational differences in postnatal care were found between the two sectors: private hospitals are more likely to have a separate postnatal care unit with single rooms and accommodate partners over-night; very few have a policy of infant rooming-in; and most have well-baby nurseries. Private hospitals are also more likely to employ staff other than midwives, have fewer core postnatal staff and have a greater dependence on casual and bank staff to provide postnatal care.

… Key differences between the two sectors relate to the organisational and aesthetic aspects of service provision rather than the delivery of postnatal care. The key messages emerging from both reviews is the need to review and monitor the adequacy of staffing levels and to develop alternative approaches to postnatal care to improve this episode of care for women and care providers alike.

And there we have it: care is not necessarily better in the private system.

What this study showed is that both the public and private health systems struggle to provide postnatal care. In both settings, staffing presents a major challenge: too many patients, not enough midwives, yet care needs to be provided. Hospital administrators in private hospitals make up this short fall by providing nurses instead of midwives in postnatal wards. The Australian College of Midwives is opposed to this because nurses are not qualified or educated to care for postnatal mothers and babies.

The private hospital staff reported “increased acuity of postnatal care” meaning that the women they are caring for have increased care needs. This may be a direct result of the high caesarean rates in private hospitals: up to 45%+. Caesareans often result in babies who do not feed as well, delayed milk production (and associated problems such as jaundice and weight loss in babies), greater need for pain relief, diminished mobility, far more observations are taken (blood pressure, temperature etc) and these women have a longer length of stay in hospital.

Added to this, the increased use of single rooms, while certainly loved by women, means that midwives have much further to travel to get to their patients. Those corridors can be pretty long in private hospitals! The staff desk and treatment room are often quite a distance from the patient’s room and numerous trips back and forth eat into the time that is available for the midwife to provide care.

Private hospitals often have a well-baby nursery where babies sleep overnight. In some hospitals, rooming-in is not encouraged (“get a good night’s sleep. We’ll look after your baby for you”) This separation of mother and baby impacts breast milk production, bonding and affects breastfeeding the following day. More breastfeeding problems = increased time required to care for each patient, but there is simply not enough midwives to provide this care. Nurses step in and formula may be suggested, compounding the problem … and so it goes on.

Yes, a private hospital looks nice, and granted the food is much better. Certain service aspects are better too: you get newspapers delivered, messages are delivered to your room and so on. But at the end of the day, people go to hospitals with the expectation of a safe birth and the provision of safe care. When care is provided by nurses, when caesarean rates are high and hospitals fail to meet the WHO Guidelines on breastfeeding, care may be compromised.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Causes of autism: Could delayed childbearing, infertility treatment, and premature birth contribute to autism?

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Research … suggests the answer is yes.
… At this point, experts can only guess at the biological basis for the links they’re finding. And those clues are not enough to recommend changes in, for example, infertility treatment.

Still, knowing who may be at risk of autism could improve diagnosis, which might enable earlier intervention.
One study … followed babies who weighed less than 4.4 pounds at birth through to age 21. Nearly 5 percent of these 623 young adults had an autism-spectrum disorder, five times the rate in the general population.

… In recent decades, women have been delaying motherhood, which increases both their chance of needing fertility treatment, and their chance of having a low-birth-weight baby, typically due to prematurity.

These changes have emerged as risk factors for autism:
Two studies … linked infertility treatment to the chance of autism … ovulation-inducing drugs … nearly doubled the odds of having an autistic child … autistic children … were three to four times more likely to have been conceived through in-vitro fertilization and to have been born at very low weights than children in the general population. The mothers of autistic children were also older …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Caesareans take toll on babies

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Babies born by caesarean section are more vulnerable to asthma, allergies and infection because they miss out on receiving their mothers’ good bacteria during birth.

… This bacteria … [colonises] the intestine …

“This can have long-term health implications, as the development of a good intestinal ecosystem is necessary for health and immunity to allergies, from childhood right through to adulthood.”

… emergency caesareans, performed after labour had already begun, meant babies did receive some of the beneficial bacteria, particularly if the waters had broken.

However, elective caesareans … gave babies no chance to pick up any of the good bacteria.

… Australian College of Midwives vice-president Hannah Dahlen said babies born vaginally also had the advantage of hormonal surges during labour that made them more wide-eyed and able to connect with their mothers. Both mother and baby experienced a surge in catecholamines, the fight-or-flight hormone, during labour, making babies more alert at birth.

… white blood cells in babies born by caesarean were different to those of babies born vaginally, potentially altering the way their bodies responded to attacks on their immune systems for the rest of their lives.

The studies could explain dramatic increases in rates of diabetes, testicular cancer, leukaemia and asthma among babies born surgically, said Associate Professor Dahlen.

”In labour, the baby has a gradual escalation in its stress response and then a gradual decline. Research has shown that this could prime our bodies to respond to stress in a certain way,” she said.

”With a c-section, there is a … dramatic stress response. It could be setting that child up to always over-respond to stress.”

… previous studies … found babies born surgically had a 20 per cent increased risk of developing diabetes …
Melissa Maimann, Essential Birth Consulting 0400 418 448

Early Clamping Of The Umbilical Cord May Interrupt Humankind’s First ‘Natural Stem Cell Transplant’

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… Delaying clamping the umbilical cord … allows more umbilical cord blood volume to transfer from mother to infant and, with that critical period extended, many good physiological “gifts” are transferred through ‘nature’s first stem cell transplant’ occurring at birth.

… [In] Western medical practice, early clamping … remains the most common practice … perhaps because the benefits of delaying clamping have not been clear. However, waiting for more than a minute, or until the cord stops pulsating, may be beneficial …

Birthing methods have also changed over the last century. Throughout human history and currently in cultures and areas where delivering mothers squat to deliver, gravity helps speed the stem cell transfer …

… the relationship between cord clamping time and the transfer of stem cells needs to be understood through the early weeks of the perinatal period and the process of ‘hematopoiesis,’ the formation of blood cells that begins as early as two weeks into pregnancy. A transfer of pluripotent stems cells continues throughout pregnancy, however, and for a time through the umbilical cord following delivery.

…”In pre-term infants, delaying clamping the cord for at least 30 seconds reduced incidences of intraventricular hemorrhage, late on-set sepsis, anemia, and decreased the need for blood transfusions.”

Another potential benefit of delayed cord clamping is to ensure that the baby can receive the complete retinue of clotting factors.

… many common disorders in newborns related to the immaturity of organ systems may receive benefits from delayed clamping. These may include: respiratory distress; anemia; sepsis; intraventricular haemorrhage; and periventricular leukomalacia. They also speculate that other health problems, such as chronic lung disease, prematurity apneas and retinopathy of prematurity, may also be affected by a delay in cord blood clamping …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Another reason to birth at home? Mothers brought the wrong baby to breastfeed.

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Babies are being handed to the wrong mothers who are unknowingly breastfeeding another woman’s child, with a string of dangerous hospital blunders in New South Wales exposing both mums and newborns to disease.

In one shocking case uncovered in an investigation … a newborn baby had to have its stomach pumped after being given month-old breastmilk from a woman who was not the child’s mother.

At least 26 cases where babies have been wrongly identified have occurred in NSW public maternity wards in the past three years. Staff shortages and the failure by some midwives to check identification tags have been blamed for the errors.

After a year-long investigation, documents released under Freedom of Information reveal the extent of the bungles.

One of the most serious cases was at Blacktown Hospital … with a baby given unnecessary medication because of incorrect identification tags.

In another incident, a 10-hour-old baby girl was given to the wrong mother to be breastfed at Westmead Hospital … because staff did not check the identification tags properly.

At least half of the errors … occurred in the Sydney South West Area Health Service …

It is the same health service which tried to hide its mistakes by refusing to release the documents until ordered by the Ombudsman.

Documents released by the hospitals reveal mothers have been left distraught after being told,or discovering themselves, the child they were breastfeeding was not theirs.

… NSW Health’s breast-milk safe management policy advises staff to double-check ID tags on the baby’s ankles and wrists against the mother. Expressed milk should be cross checked with the mother and ideally stored in a fridge in her room …

These problems can be avoided by birthing at home. If a woman births in hospital, it is important to avoid separation from the baby, even if she is tired. Midwives typically care for 8-15 women on afternoon and night shifts and this can obviously impact patient care. It does not excuse the issue, but with a huge shortage of midwives, keeping your new baby with you can help minimise your chances of being handed someone else’s baby, or having your baby handed to another mother.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Infertility treatments may raise preterm birth risk

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Couples who conceive through … IVF or … ICSI had a higher risk of preterm delivery.

… nearly 8 percent were premature and 1.5 percent were very premature …

… roughly 5 percent of babies born to fertile mothers were premature, and 0.6 percent were very pre-term …

… Other forms of fertility treatment … were not related to the risk of preterm delivery.

[The study only looked at singleton babies, so the findings could not be explained by a higher proportion of twins] … the findings suggest that something about the IVF and ICSI procedures themselves might raise the odds of preterm birth.

… The fact that other forms of fertility treatment were not linked to preterm delivery suggests that infertility itself is not to blame …

… Another possibility … has to do with the “vanishing twin” phenomenon … these surviving fetuses are at increased risk of preterm delivery and low birth weight …

Melissa Maimann, Essential Birth Consulting 0400 418 448

FAQs

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What are the disadvantages of birthing in hospital?

Most women who birth in hospital do not have the same midwife with them throughout pregnancy, birth and the postnatal stay. They have different midwives for pregnancy care, then another lot of midwives for the birth (sometimes 3-4, depending on how long the woman is in delivery suite and whether the midwife has a student midwife working with her), followed by another lot of midiwves who work in shifts in postnatal. The lack of continuity means that the woman does not have the opportunity to really develop a deep sense of trust with her own midwife, something that is intrinsic to positive and safe birthing experiences.

Women who are attended by hospitals have hospital policies drive their care. Policies around induction: when and how it’s done; when a caesarean is done; how often they are to be examined; which women are to be continuously monitored; which babies are to be admitted to the nursery and so on. It’s a bit like checking a box and then applying a treatment or intervention – without first checking if that treatment or intervention is genuinely needed in the woman’s case.

When women have their own midwife with them – either for hospital, birth centre or home birth, they have the full range of options open to thema nd they are fully informed and able to make their own decisions around pregnancy and birth care.

birthing options

To learn more about birthing options, why not come along to the Essential Birth Consulting workshops?

Can I have a midwife as additional support in pregnancy?

Absolutely! It’s a great way to supplement and complement the care option that you have chosen. You can have a midwife as additional support whether you’re going to a public or private hospital, and even if you also have a private obstetrician. See here for details of birthing statistics with and without your own midwife.

midwife medical offset?

It’s called the net medical expenses tax offset. Contact your registered tax agent or accountant for more advice. my understanding is that once you have $1500 in out-of-pocket medical expenses (doctor’s fees, midwifery, prescriptions, optical, dental etc) you can claim 20% the cost through tax.

midwifery care fees

Private midwifery costs somewhere between $3000 and $6000. Essential Birth Consulting has new payment structure where families may choose to pay by the hour, potentially making this the best value midwifery service in Sydney, at around $3000 for a complete package of pregnancy, birth and postnatal care. Birth support is available for around $1500.

Are there any homebirth classed in sydney?

Yes! Why not come along to the Essential Birth Consulting workshops?

access to rebate on midwife visits

After November this year, women who are planning a hospital birth with a private midwife will be able to claim a medicare benefit for midwifery services. The benefit amount is not known at this stage and it is likely that there may be some out-of-pocket expenses too, but it will bring down the cost once Medicare benefits are payable.

Are hospital births unnecessary?

Every woman will need to come to her own conclusions on this one. My opinion is that home is the safest place for a low-risk, healthy woman to birth her baby. Leave hospitals for those who need them! In that case, most women would actually birth at home.

bowral midwife educator

I’d recommend Peter Jackson’s Calmbirth classes.

Can i have an epidural with a midwife?

Absolutely! Although many women find that they don’t need one when they’re cared for by the same midwife and supported well in labour. My experience has been that the call for an epidural is mostly a call for more support and suggestions for getting though the labour. Epidurals are a good option for some women in some labours.

Can midwives administer oxytocin at a home birth?

Yes, if it’s to manage excessive bleeding after the baby is born, but we cannot use it to induce or augment the labour. Those interventions must be attended in the hospital as they carry risks to the baby. Midwives routinely carry oxytocics to births in case they are needed.

Cost of homebirths in the illlwarra

Private midwifery costs somewhere between $3000 and $6000. Essential Birth Consulting has new payment structure where families may choose to pay by the hour, potentially making this the best value midwifery service in Sydney, at around $3000 for a complete package of pregnancy, birth and postnatal care.

Does having gestational diabetes mean a c section?

This would be a good one to ask your care provider. Generally speaking, gestational diabetes does not automatically mean having a caesarean.

Private midwife public hospital sydney?

Yes, it is possible to take your own midwifey with you in a public hospital. This service provides this as an option. Women book with their private midwife, booki into the hospital, receive all of their pregnancy care from their midwife, labour at home as long as possible with their midwife (even having the option of staying home if all is well), head off to hospital when the time is right, and then come home as soon as possible and continue care for 6 weeks. In the hospital, a hospital midwife will also be assigned to you.

Pprivate midwives in Sydney’s east?

Yes, this service provides private midwifery services in the eatern suburbs.

Reasonable obstetricians north shore 2010

What is reasonable? What is important to you? At the end of thr day, it’s about choosing a care provider who is suited to your needs. As experts in abnormal pregnancy and surgery, obstetricians are ideal care providers for risk-associated pregnancies. If your pregnancy is normal and you prefer a more natural option, midwifery care will best meet your needs. Private midwifery is the oldest form of continuity of midwifery care, however there is a price attached to this model as it is a private service. Public options are free but will lead you down the path of hospital policy and interventions.

What is the difference in cost between public and private?

Private has costs attached: obstetrician, paediatrician and anaesthetist fees, private hospital fund excess / co-payment, any other fees and charges from the private hospital (eg TV, phone, parking etc) and also tests and ultrasounds. Public is free if you have a Medicare card.

Transition into parenthood

These are highly recommended childbirth education classes that prepare couples well for the changes in pregnancy, birth and parenthood.

vbac north shore private?

It’s very unlikely to happen at North Shore Private! Around 5% of the women who have previously had a caesarean go on to have a vaginal birth in that hospital. Private midwifery care – either for home birth or hospital birth – increases that percentage to 80-90%.

water birth private hospital sydney

None of the private hospitals in Sydney allow waterbirth. Waterbirth is the norm in a homebirth and may be an option in a public hospital if there are midwives on shift – and baths / pools available – to facilitate this.

Melissa Maimann, Essential Birth Consulting 0400 418 448

FAQs

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informed consent and childbirth

Every woman who is competent to consent, has the right to refuse any or all professional care. Informed consent must be obtained prior to any procedure being performed.

how to minimise labour intervention in a hospital?

The best way to minimise intervention in a hospital is to be as well informed as you can possible be about all things related to pregnancy, labour, birth, breastfeeding and babies. Read widely, attend independent childbirth education classes and consider employing a private midwife to be with you throughout your labour. She can help you to decide if the proposed interventions are necessary in your situation, she can support you emotionally, mentally and physically and she can aso help to ensure that your birth plan is respected without a fuss.

Do any independent midwives in Sydney offer prenatal care for women who are planning to freebirth?

Yes! This service enables women to access antenatal care from a midwife without the midwife attending the birth. Postnatal care is available if needed.

Do you think there are advantages to continuous monitoring for low-risk women

In a word, no. Intermittent auscultation is the method of choice. Continuous monitoring will increase the chance of a caesarean with no benefit to the mother or baby.

How much is a private midwife

Prices range from $3000 – $6000. Melissa Maimann offers for her clients to pay by the hour, making the service one of the cheapest.

What is a good caesarean rate?

The World Health Organisation recommends that no more than 15% births need to be caesareans. The WHO argues that when caesarean rates exceed 15%, the risks to the mother and baby increase on the whole. You’ll be hard-pressed to find a hospital with a caesarean rate of less than 15%, but birth centres and private midwives have caresarean rates of less than 10-15%.

What is the best hospital in sydney for delivering babies?

It all depends what sort of birth experience you’re after! If you’re wanting a natural birth, home birth will be the best option. If you want a natural birth in a hospital setting, the best options would be birth centre or private midwifery care for a planned hospital birth. If you’re wanting to have intervention in your birth, a hospital birth would be best. If you choose an obstetrician, you’re far more likely to have a caesarean, episiotomy, epidural, forceps or vacuum. Choosing your care provider is the single most important decision you will make in birthing.

Is there a birth centre at westmead hospital?

No, there isn’t. If you’re after a natural birth, the best choice would be a home birth.

C section or natural delivery midwife?

Midwves cannot perform caesareans. If a caesarean was needed, the midwife would call a doctor in to perform it. Most caesareans that are performed are unnecessary and increase the risks to the mother and baby. A natural birth is the safest way to birth, and midwives are qualified specialists in natural birth.

giving birth after birth trauma

Private midwifery care will be really important so that you can have the same midwife all the way through pregnancy, birth and postnatally. It’s also important to debrief your last experience and come to a place where you feel safe to birth again.

high risk midwife sydney

Midwives are not qualified to care for high risk pregnancies. We refer these women onto obstetricians. In most cases, one or two consultations is all that is needed with the obstetrician and the midwife continues the care of the woman.

how many births proceed naturally

What a great question! It all depends what care provider you choose and where you have your baby. You see, if you choose a private midwife and birth at home, you have about a 95% chance of having a vaginal birth. If you birth in a private hospital, you have about a 33% chace of having an unassisted vaginal birth. In some hospitals, the caesarean rate is more than the vaginal birth rate! Sad but true.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Screening And Antenatal Diagnoses Of Down’s Syndrome

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… the number of diagnoses of Down’s syndrome has increased by almost 71 percent from 1989-90 to 2007-08. This is mostly due to the considerable increase in the number of elder mothers over this period. Yet during the same period, the number of babies born with this condition fell by one percent because of antenatal screening and subsequent terminations.

… there has been a sharp increase of 3 to 43 percent in the proportion of younger women (below the age of 37) opting for screening. However despite improved tests, the proportion of older women deciding to be screened has stayed invariable at around 70 percent.

In the case of women with an antenatal diagnosis of Down’s syndrome, the proportion who decided to terminate the pregnancy has also remained constant at around 92 percent (9 in 10).

… older women have a far greater chance of having a baby with Down’s since the risk for a 40 year old mother is 16 times that for a 25 year old mother …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Experts Still Split on Bilirubin Screening for Newborns

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… universal screening for bilirubin reduced the number of infants who developed severe jaundice, a condition that can lead to seizures and brain damage. But expert opinion and important guidelines are divided on the practice.

Infants born at hospitals with universal bilirubin screening had a 62% lower incidence of total serum bilirubin (TSB) levels exceeding American Academy of Pediatrics (AAP) guidelines compared with those born at facilities without universal screening …

Babies born at hospitals with routine screening … received twice as much inpatient phototherapy … and had slightly longer hospitalizations after birth … than those in hospitals without routine screening.

… high levels of bilirubin in the body can cause brain damage … hearing loss, eye muscle problems, physical abnormalities, and even death. The incidence of kernicterus ranges from 0.4 to 2.9 per 100,000 live births …

… early treatment can decrease the number of infants with elevated serum bilirubin levels, but found inadequate evidence that treating elevated bilirubin levels in term or near-term infants to prevent severe hyperbilirubinemia resulted in the prevention of chronic bilirubin encephalopathy, the greatest danger posed by the condition.

“Evidence about the benefits and harms of screening is lacking,” … “Thus, the USPSTF could not determine the balance of benefits and harms of screening newborn infants to prevent chronic bilirubin encephalopathy.”

… “Although screening can predict hyperbilirubinemia, there is no robust evidence to suggest that screening is associated with favorable clinical outcomes,” …

… while routine testing is an imperfect tool, it might prevent some cases of brain damage …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Women Miscalculate Time to Full-Term Birth

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I don’t agree with the suggestion that it is women who miscalculate the time to full term. While some may believe that a baby is “full term” from 37 weeks onwards, it is the obstetrician who agrees to the induction or caesarean prior to 39 weeks. I’m not comfortable with the implication that if a baby is born electively prior to 39 weeks, that it is the woman’s fault.

… the rate of preterm deliveries continues to climb … a new study suggests one reason … many women are confused about what constitutes a full-term birth …

… one-quarter of new mothers surveyed … considered a baby born at 34 to 36 weeks of gestation to be full term, while slightly more than half of women considered 37 to 38 weeks full term.

Though technically speaking, preterm births are babies born prior to 37 weeks, 39 to 40 weeks is optimal …

Many women interviewed were also unaware that babies born even a little bit premature are at a higher risk of serious health problems compared to babies born at term …

… “The data is becoming more and more clear that the outcomes of births at those earlier gestational ages are not as good as babies that are born at 39 or 40 weeks.”

… any delivery short of 39 weeks puts a baby at higher risk of respiratory distress, sepsis… and needing to be placed in the neonatal intensive care unit …

… the percentage of babies born preterm rose by more than 20 percent from 1990 to 2006 …

… the World Health Organization … defines preterm births as babies born before 37 weeks. But that definition … is outdated … studies have shown that babies born … at 37 or 38 weeks have a greater chance of chronic respiratory disease and learning disorders than children born at 39 weeks or later.

Babies born between 34 and 37 weeks are six times more likely to die during their first week or life and three times more likely to die during their first year than babies born at 39 or 40 weeks …

… The last few weeks of gestation are critical to fetal development. All of the organs continue to mature in preparation for moving from the womb to the outside world … between 35 and 40 weeks, the fetal brain grows by about 50 percent …

Melissa Maimann, Essential Birth Consulting 0400 418 448

DIY fetal heart rate monitors

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The joys and worries of pregnancy… can be numerous. One way moms-to-be often comfort themselves is with an at-home personal fetal monitor (Doppler device). The sound of baby’s heartbeat is certainly reassuring, but can the sounds of a normal heartbeat give the entire picture of a growing infant’s health?

A hand-held Doppler device assesses the presence of fetal heart pulsations only at that moment, and it is used by midwives and obstetricians … “In untrained hands it is more likely that blood flow through the placenta or the mother’s main blood vessels will be heard,” say the authors.

The article outlines a case of a … mom-to-be (at 32 weeks into her first pregnancy) with reduced fetal movements; She had first noted a reduction in her baby’s activity two days earlier but had used her own Doppler device to listen to the heartbeat and reassured herself that everything was normal.

… Speaking as the mother of two sons born in a birthing tub at home, assisted by midwives, I can agree that it is tempting to try to assuage worries for our baby’s health using a variety of methods … The bottom line: A safe … birth of a healthy infant requires regular and attentive care by a … midwife or doctor. There are no appropriate substitutes for experienced care by qualified health practitioners.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Put The Safety Of Babies And Their Mothers Ahead Of Home Birth Ideology

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The title of this article is offensive to say the least! The vast majority of home birthing women do not put home birth ideology ahead of a safe birth.

Australia’s peak group of obstetricians and gynaecologists today repeated its warning that home births – with or without a midwife – carry too much risk to babies and their mothers and the Government should resist calls to indemnify midwives outside of hospitals.

For starters, she does not seem to even acknowledge the difference between midwife-attended home births and free births.

The President of the National Association of Specialist Obstetricians and Gynaecologists (NASOG), Dr Hilary Joyce, congratulated the Government-majority Senate Committee investigating proposed legislation relating to the role of midwives, for putting the safety of babies ahead of protestations by a small but vocal minority of people.

“I would urge all politicians to look to the evidence and to speak to the doctors and the midwives who have to deal with some of the tragic consequences of home births,” Dr Joyce said today.

“Australia has one of the safest and highest quality maternity services in the world where specialist doctors work side by side with qualified midwives to ensure babies and their mothers have a safe and successful birth experience.”

Safe and successful? Many women who enter the hospital system to give birth come away traumatised. The majority of women who birth at home with a midwife are happy and satisfied with their experience. Rates of mortality are the same for low risk women whether they birth at home or in hospital. But morbidity is far higher in hospital.

… “There is irrefutable evidence that women and babies are significantly safer in hospitals because of the immediate access to specialist care. Thankfully, only 0.25% of Australian women risk their lives and that of their babies by choosing a home birth.”

I’d like to see this irrefutable evidence. I cannot find it. “only 0.25% of Australian women risk their lives and that of their babies by choosing a home birth.” – is this offensive or what? The vast majority of home birthing women I know will not risk their baby’s life or their own simply to birth at home.

Dr Joyce said the Minister for Health and Ageing was acting in the best interests of babies and their mothers by refusing to financially endorse the unsafe practice of delivering babies at home.

“There are things that can go wrong suddenly in a birth which, if not under specialist care or near medical assistance, can result in an avoidable death or permanent injury,” Dr Joyce explained …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Warning Over Home Fetal Heart Rate Monitors

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Expectant mothers are being warned over the use personal monitors, such as Doppler devices, to listen to their baby’s heartbeat at home. There is concern that they may lead to delays in seeking assistance for reduced fetal movements.

Dr Thomas Aust and colleagues from the Department of Obstetrics and Gynaecology at Arrowe Park Hospital, Wirral, UK describe the case of a 27 year old woman … . She presented to their labor ward 32 weeks into her first pregnancy with reduced fetal movements.

Two days earlier, she had first noted a reduction in her baby’s activity. But she had used her own Doppler device to listen to the heartbeat and reassured herself that everything was normal.

Additional monitoring by the antenatal care team raised the alarm. The baby was delivered by caesarean section later that evening …

The authors explain that a hand-held Doppler device assesses the presence of fetal heart pulsations only at that moment. It is used by midwives and obstetricians … In inexpert hands it is more probable that blood flow through the placenta or the mother’s main blood vessels will be heard.

… a fetal Doppler device could be hired for £10 (about 16.46 USD) a month or bought for £25 to 50 (about 41 to 82 USD) … The companies offering sales state that the device is not intended to replace recommended antenatal care. However, they also make claims such as “you will be able to locate and hear the heartbeat with excellent clarity” …

I have always been concerned about use of dopplers in this way. Midwives and obstetricians are trained to interpret the baby’s heart rate in relation to what is happening for the woman at the time. The best advice for parents is to call your midwife or doctor if you’re concerned about your baby – if you feel that something isn’t right, or if your baby is not moving as much as s/he usually moves.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Low Choline Level in Pregnancy Tied to Birth Defects

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Low blood levels of the nutrient choline during pregnancy increases the risk of brain and spinal-cord defects in newborns …

They focused on two types of neural tube birth defects — anencephaly and spina bifida …

… choline levels were linked to risk of neural tube defects. Choline is found in egg yolks, soy, wheat germ and meats.

Women with the lowest blood choline levels during pregnancy were 2.4 times more likely to have infants with neural tube defects than women with average blood choline levels. Women with the highest choline levels had the lowest risk.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Study Examines Reduction In Birth-Related Rate Of Death Of Infants Born At Term

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During about the last 20 years, the risk of delivery-related death at birth or shortly thereafter for term infants has decreased nearly 40 percent in Scotland, with the largest contributing factor being a decrease in the number of deaths caused by a lack of oxygen for the baby during the childbirth process …

Rates of obstetric intervention in labor, including cesarean delivery, have increased significantly in most developed countries. “It is, however, unclear if this has been paralleled by decreased rates of perinatal [pertaining to the period immediately before and after birth] and neonatal death associated with complications of labor at term,” …

… The study included … all single infant births in a cephalic presentation at term (n = 1,012,266), excluding those with perinatal death due to congenital anomaly or antepartum (before birth) stillbirth.

There were 719 delivery-related perinatal deaths (0.07 percent) during the study period, which included 219 intrapartum stillbirths [and] 500 neonatal deaths … Of these perinatal deaths, 432 (60.1 percent) were attributed to intrapartum anoxia … and 287 (39.9 percent) were attributed to other causes.

The absolute risk of delivery-related perinatal death in the population was 7.1 per 10,000 births. When modeled between 1988 and 2007, there was a decrease in the risk of delivery-related perinatal death from 8.8 to 5.5 per 10,000 births … When analyzed by the cause of death, there was a statistically significant reduction in the incidence of death attributed to intrapartum anoxia from 5.7 to 3.0 per 10,000 births …

… “The pattern of the decline suggests that this was primarily due to a reduced number of severely anoxic infants rather than improved neonatal resuscitation. The change was paralleled by increased rates of cesarean delivery, but there is no direct evidence supporting a causal association between the 2 trends.”

Melissa Maimann, Essential Birth Consulting 0400 418 448

Possible Genetic Link To Cause Of Pregnancy Loss And Disorders

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Scientists … have published new findings about a cause of a condition at the root of genetic disorders such as Down Syndrome, pregnancy loss and infertility.

Called aneuploidy, the condition is an abnormal number of chromosomes, and the research team found that if a mother’s egg cell has a mutation in just one copy of a gene, called Bub1, then she is less likely to have offspring that survive to birth.

… the harmful effects of this mutation increased with a mother’s age. As the female mice got older, there was eventually a complete loss of their ability to support a full-term pregnancy that lined up with an increase in aneuploidy. The same is true in humans: the chance of having an aneuploid pregnancy increases with the age of the mother.

Melissa Maimann, Essential Birth Consulting 0400 418 448

New Study On The Cause Of Early Preterm Birth

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… women going into early preterm labour … have low-levels of progesterone in their saliva as early as 24 weeks … and these levels fail to rise during pregnancy in the normal way …

… progesterone is known for its anti-inflammatory properties, and … low levels of the hormone … could contribute to bacterial infection, a recognised cause of early preterm labour …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Women Who Quit Smoking Early In Pregnancy Reduce Risks Of Preterm Birth, Stunted Fetal Growth

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Pregnant women who quit smoking during the first trimester and women who never smoked during pregnancy have a similar risk of delivering preterm or very small infants … Premature delivery and stunted infant growth are the most well-documented side effects of smoking during pregnancy, and the risks increase for older women …

… Fifteen percent of women who smoked the entire pregnancy gave birth to full-term infants who were small for their gestational age, while 2% gave birth to premature infants who were small for gestational age. Among women who quit smoking during the first trimester, these outcomes occurred 9% and 1% of the time, respectively.

… women who quit smoking in the first trimester reduced their risk of giving birth to a preterm, normal-size infant by 31%. The risk of delivering a full-term, unusually small infant was cut by 55% and the risk for delivering a preterm, unusually small infant was reduced by 53%. … the risk reduction was particularly high for older women … who quit smoking during the first trimester …

Melissa Maimann, Essential Birth Consulting 0400 418 448

C-Section Anesthetics Not Linked to Learning Disabilities

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Anesthesia during a cesarean delivery is not associated with an increased risk of learning disabilities compared with vaginal birth …

The finding … suggests that brief exposure to anesthetics during birth has no long-term neurodevelopmental consequences … in an unexpected finding, regional anesthesia during cesarean was associated with a lower risk of learning disabilities compared with vaginal birth …

One possible explanation for that … is that cesarean delivery with regional anesthesia “attenuates the neonatal stress response to vaginal delivery that in turn has significant effects on later neural development.”

… The issue has been of concern, since animal studies have shown that anesthetics can cause degenerative changes when applied to the young brain.

… Among those delivered vaginally, the cumulative incidence of learning disabilities was 20.8%, compared with 19.4% for those whose mothers received general anesthesia for cesarean delivery and 15.4% for those whose mothers had a regional anesthetic for cesarean delivery.

… the pairwise comparison of vaginal birth with cesarean delivery and regional anesthetic yielded a hazard ratio of 0.73, which was significant at P=0.046.

Melissa Maimann, Essential Birth Consulting 0400 418 448

If Breast Is Best, Why Are 70% of U.S. Hospitals Pushing Formula?

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The majority of U.S. hospitals are providing formula packets … to breastfeeding mothers while nearly one-fifth of hospitals give something other than breast milk as a first feeding to … babies … This practice contradicts the best medical evidence available …

Breast milk … provides … antibodies and essential nutrients … breastfeeding benefits [include] decreased risk of diabetes, obesity, juvenile leukemia, heart disease, asthma and ear infections. Breastfed children also have been found to have better jaw and eye development than those who are not breastfed.

… breastfeeding helps a uterus return to its normal size. It may help a new mother lose pregnancy weight, and studies show that it reduces the risk of breast and ovarian cancer … breastfeeding [increases] bonding between mother and baby.

Melissa Maimann, Essential Birth Consulting 0400 418 448

No Psychological Risk In Children Next-Born After Stillbirth

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There is no evidence that children next-born after stillbirth are clinically at risk compared to children of non-bereaved mothers … However, the study did find evidence of less optimal mother-child interaction.

Anecdotal accounts have suggested that children born subsequent to stillbirth of a sibling may be psychologically vulnerable …

The researchers found no significant between-group differences in child cognitive or health assessments … However, mothers … reported increased child difficulties … and there were higher levels of maternal criticism of the child’s behaviour …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Memory Forms at 30 Weeks in the Womb

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Fetuses that are only 30 weeks old may already possess short-term memory …

… The authors stated that habituation is a form of learning and needs an intact central nervous system.

… According to background information in the paper, the first study to look at fetal habituation took place in 1925 and involved repeated honking of a car horn. Since then, similar studies have been conducted with electric toothbrushes and door buzzers, as well as the vibroacoustic stimulator.

In this study, fetuses were exposed to the vibroacoustic stimulation at 30, 32, 34, 36 and 38 weeks’ gestation.

Fetuses as young as 30 weeks demonstrated a short-term memory of 10 minutes, and fetuses at 34 weeks seemed able to remember information they stored four weeks prior, the authors stated …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Chemicals In Common Consumer Products May Play A Role In Pre-Term Births

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A new study of expectant mothers suggests that a group of common environmental contaminants called phthalates, which are present in many industrial and consumer products including everyday personal care items, may contribute to the country’s alarming rise in premature births.

… women who deliver prematurely have, on average, up to three times the phthalate level in their urine compared to women who carry to term.

… Premature birth is a significant risk factor for many health problems in childhood that can persist into adulthood … In the United States, premature births have increased by more than 30 percent since 1981 and by 18 percent since 1990. In 2004, premature births accounted for 12.8 percent of live births nationwide.

Premature births … account for one-third of infant deaths in the United States, making it the leading cause of neonatal mortality. Being born too early can also lead to chronic health problems such as blindness, deafness, cerebral palsy, low IQ and more.

Phthalates are commonly used compounds in plastics, personal care products, home furnishings (vinyl flooring, carpeting, paints, etc.) and many other consumer and industrial products … past studies show that several phthalates cause reproductive and developmental toxicity in animals.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Bottle-Feeding Moms Ignored

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The lack of information and support for mothers who bottle-feed could put the health of their infants at risk …

… Variations in bottle-feeding can have long-term health consequences for children …

… Some mothers who bottle-fed … experienced negative emotions such as guilt, worry about the impact on their baby, concern about health professionals’ opinions, uncertainty about how to proceed, a sense of failure and anger at feeling pressure to breast-feed.

Some mothers said they didn’t receive enough information on correct bottle-feeding techniques …

It was common for mothers to make mistakes in bottle-feeding preparation. Incorrect preparation can increase the risk of infection, promote excessive weight gain or leave babies undernourished.

It’s important to promote breast-feeding because it’s the healthiest option for both mother and baby … But … it’s “also necessary to ensure that the needs of bottle-feeding mothers are met … Inadequate information and support for mothers who decide to bottle-feed may put the health of their babies at risk.”

Melissa Maimann, Essential Birth Consulting 0400 418 448

Colostrum Functions Like Human Growth Hormone

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Colostrum … is the first food, in which all the immune and growth factors that insure health and vitality are transferred from the mother to the newborn. Research has shown that colostrum is the one supplement that can bring help to everyone that uses it, largely because of its ability to perform many of the functions of human growth hormone (HGH) in the body … colostrum can prevent the death of human neurons and effectively treat Alzheimer’s patients. … Colostrum knocks out intestinal inflammation.

… a proline-rich polypeptide isolated from colostrum, can effectively treat Alzheimer’s disease patients.

… Colostrum works in a unique manner to protect the body from pathology. Most pathogens enter the system through the mucous membranes of the intestinal tract. Bacteria, viruses, pollutants, contaminants and allergens must be combated there. … a high percentage of the antibodies and immunoglobulins present in colostrum are not absorbed but remain in the intestinal tract. Immune factors work there to support proper immune function and healthy intestinal flora …

… Colostrum is the essence of pure nutrition, containing immunoglobulins, growth factors, antibodies, vitamins, minerals, enzymes, amino acids, and other special substances designed to prime the body to face a lifetime of invasion by various microorganisms and environmental toxins bent on destruction.

Even more data to support breastfeeding!

Melissa Maimann, Essential Birth Consulting 0400 418 448

Infertile Couples Encouraged To Look At Lifestyle

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A … study has recommended that infertile couples seek advice about their lifestyle before embarking on IVF treatment or other assisted reproductive technology.

… while most people link obesity, smoking, drugs and stress to infertility problems, many infertile couples fail to look at their own lifestyle as a possible obstacle to conceiving.

… only half of the overweight women in this study considered their own weight to be a risk factor for infertility.

… overweight women are also at risk of pregnancy complications such as miscarriage, gestational diabetes and raised blood pressure.

… The study underlines the importance of good preconception advice and support …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Pregnancy Complications Are A Stress Test For Future Maternal Health And Pregnancies

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… women who have had two pregnancies complicated by preeclampsia are at a higher risk of hypertension after pregnancy.

… “while delivery may ‘cure’ preeclampsia in the moment, these mothers are at high risk of chronic hypertension, type 2 diabetes mellitus and blood clots for the rest of their lives. Pregnancy acts like a natural stress test for women.”

… the research adds to growing data on the link between hypertensive pregnancy disorders, diabetes, cardiovascular disease and maternal death …

… preterm delivery, preeclampsia and low-birth weight tend to recur and predispose to each other in a second pregnancy. The severity of the complication in the first pregnancy further increases these risks.

… if their first pregnancy resulted in a delivery between 32 and 36 weeks of gestation, the risk of a preterm delivery in the second pregnancy increased to 14.7% … if their first pregnancy resulted in an even earlier preterm delivery- between 28 and 32 weeks of gestation-the risk of a preterm delivery in the second pregnancy increased to 25.4%. Delivery between 20 and 27 weeks in the first pregnancy doubled the risk for delivering a baby that was small for gestational age in the second pregnancy.

… spontaneous preterm delivery, preeclampsia, low fetal growth, placental abruption and stillbirth in a first and second pregnancy are interrelated,” … “Perhaps they all may be features of a ‘placenta-associated syndrome.’ …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Pregnancy Complications May Increase Autism Risk

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Complications during pregnancy may increase the risk of having a child with autism …

The team reviewed 64 studies of prenatal risk factors for autism. It is the first time a meta-analysis of the relationship between pregnancy-related factors and risk of autism has been carried out …

… the factors most strongly associated with an increased autism risk are:

- Being born to an older mother or father.
- Having a mother who was born abroad.
- Having a mother who experienced bleeding during pregnancy.
- Having a mother who experienced gestational diabetes.
- Having a mother who used medication during pregnancy.
- Being the first born – or later born in families where there are three or more children.

… Mothers who are born in another country may not have natural resistance to infections in the country where they give birth, which may increase the risk for autism. Moving to another country may also put women under stress, which could increase their chances of having a child who develops autism.

Bleeding during pregnancy, gestational diabetes and medication use are also associated with increased autism risk. Bleeding can cause foetal hypoxia … Women who develop diabetes during pregnancy experience hormonal and metabolic changes, which may affect their baby’s health and development. Foetal development may also be affected by some medications which can cross the placenta during pregnancy.

The association between birth order and autism risk is unclear …

“There is some evidence to suggest that exposure to pregnancy complications in general may increase the risk of autism.”

Melissa Maimann, Essential Birth Consulting 0400 418 448

Repeat Elective Caesarean Before 39 Weeks Increases Neonatal Risk

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If a woman who has had a Caesarean delivery has another such elective procedure before 39 weeks of gestation, the risk of an adverse neonatal outcome increases by 50% or more …

A repeat elective Caesarean at 38 weeks was associated with an odds ratio of 1.5 for adverse outcomes, increasing to 2.1 for Caesarean delivery at 37 weeks …

Adverse respiratory outcomes, need for mechanical ventilation, newborn sepsis, hypoglycemia, admission to the neonatal ICU, and hospitalization for five days or longer all occurred more often in babies delivered by Caesarean before 39 weeks of gestation.

“These early deliveries are associated with a preventable increase in neonatal morbidity and admissions to the neonatal ICU, which carry a high economic cost,” the authors concluded. “These findings support recommendations to delay elective delivery until 39 weeks of gestation and should be helpful in counseling.”

… Approximately 40% of Caesarean deliveries are repeat procedures. As the number of procedures increases, so do the public health implications related to the timing of delivery …

… Compared with births at 39 weeks, births at 37 weeks had more than a two-fold increased risk of the primary outcome (OR 2.1, 95% CI 1.7 to 2.5). For births at 38 weeks, the hazard remained increased (OR 1.5, 95% CI 1.3 to 1.7) …

The authors noted that they “also observed a higher risk of neonatal complications with Caesarean delivery at 41 weeks or later although the overall proportion of mothers delivering this late was small (<5%)."

Melissa Maimann, Essential Birth Consulting 0400 418 448

C-Section Births Cause Genetic Changes That May Increase Odds For Developing Diseases In Later Life

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… babies born by Caesarean section experience changes to the DNA pool in their white blood cells, which could be connected to altered stress levels during this method of delivery …

It is thought that these genetic changes, which differ from normal vaginal deliveries, could explain why people delivered by C-section are more susceptible to immunological diseases such as diabetes and asthma in later life, when those genetic changes combine with environmental triggers.

… “Delivery by C-section has been associated with increased allergy, diabetes and leukaemia risks” … “Although the underlying cause is unknown, our theory is that altered birth conditions could cause a genetic imprint in the immune cells that could play a role later in life.

… As the diseases that tend to be more common in people delivered by C-section are connected with the immune system, we decided to focus our research on early DNA changes to the white blood cells.”

The authors point out that the reason why DNA-methylation is higher after C-section deliveries is still unclear and further research is needed. “Animal studies have shown that negative stress around birth affects methylation of the genes and therefore it is reasonable to believe that the differences in DNAmethylation that we found in human infants are linked to differences in birth stress. “We know that the stress of being born is fundamentally different after planned Csection compared to normal vaginal delivery. When babies are delivered by Csection, they are unprepared for the birth and can become more stressed after delivery than before. This is different to a normal vaginal delivery, where the stress gradually builds up before the actual birth, helping the baby to start breathing and quickly adapt to the new environment outside the womb.”

… “C-section delivery is rapidly increasing worldwide and is currently the most common surgical procedure among women of child-bearing age. Until recently, the long-term consequences of this mode of delivery had not been studied. However, reports that link C-section deliveries with increased risk for different diseases in later life are now emerging. Our results provide the first pieces of evidence that early ‘epigenetic’ programming of the immune system may have a role to play.” The authors feel that their discovery could make a significant contribution to the ongoing debate about the health issues around C-section deliveries.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Researchers Say Stress In The Womb Can Last A Lifetime

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… The placenta is crucial for fetal development and it usually protects the unborn baby from the stress hormone cortisol. However, when the mother is stressed, the placenta becomes less protective and the mother’s cortisol may have an effect on the fetus.

… maternal stress and anxiety can alter the development of the baby’s brain. This in turn can result in a greater risk of emotional problems such as anxiety or depression, behavioural problems such as Attention Deficit Hyperactivity Disorder, and being considerably slower at learning. Some studies have even suggested that it may increase the likelihood of later violent or criminal behaviour. Their findings have suggested that the effects of stress during pregnancy can last many years, including into adolescence.

… The researchers say that the stress hormone cortisol may be one way in which the fetus is affected by the mother’s anxiety during pregnancy. Usually the placenta protects the unborn baby from the mother’s cortisol, by producing an enzyme that breaks the hormone down. When the mother is very stressed, this enzyme works less well and lets her cortisol through the placenta. … the Imperial researchers’ latest study suggests that the higher the level of cortisol in the womb, the lower the toddler’s cognitive development or “baby IQ” at 18 months.

Melissa Maimann, Essential Birth Consulting 0400 418 448

No more tears

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Howard Chilton has probably cradled a small percentage of Sydney’s locally born population in his arms. The specialist in newborn babies has devoted his career to the pointy end of medicine, keeping alive infants the size of a matchbox and inventing medical devices to help his work.

But after three decades, two of which he was director of pediatrics at the Royal Hospital for Women, the respected doctor has turned his attention to their often-anxious parents, risking facing the ire of many women in the heated debate on mothercraft.

… “I desperately want parents to enjoy their babies,” he says. “Mostly I call myself a reassurologist.”

… “If you want to have an independent baby, love-bomb them,” he declares. Feed them, cuddle them, let them rule your world. For the first six months of their lives at least….

… new interests have replaced old ones. He wants to convince health authorities to fund human milk banks across Australia for infants who need breast milk. Despite the fact that such services are common in other developed countries, he seems remarkably patient with the slow progress here. “They will move at their own speed,” he says.

… Perhaps more engrossing is his passion for educating parents against trying to create order in their new life with a tiny baby. Still a visiting medical officer at the Royal and in private practice, he wants to ensure such ideas for infants aged younger than six months are banished for good.

Every Thursday morning he meets new parents at the Royal to deliver his message. His group talk started because he found he was being asked the same questions again and again. The most pressing being how to settle a crying, distressed baby.

“I enjoy one-on-ones but one on 30 is a more efficient way of helping parents, reassuring parents that they are capable of looking after their baby.”

His introduction to parenthood has blossomed into an hour-long guided tour that begins with evolution. Humans are born premature, with brains that are only 25 per cent formed. Because humans walk on two feet, the birth canal in women is too narrow to allow a large, more fully developed brain to fit through the pelvis.

Because babies are therefore not fully formed at birth, parents should replicate the baby’s experience in the womb by providing a secure, quiet and well-fed environment for the first months after birth. He tells mothers to ignore age-old rules of mothercraft, urging them not to bother burping their babies, to breastfeed them (if possible) as much the baby wants, to sleep with them (under correct conditions) and not to let them get distressed if avoidable.

Chilton has been known to urge his audience to throw out any copies of the likes of best-selling author Gina Ford …

“I think the [likes of] Gina Ford are attractive to a small section of the population, usually career women who want their babies to fit into a template … teachers and accountants, people who really like things to be timetabled,” he says.

In reality, only about 15 per cent of babies conform to sleeping and eating at the whim of the parent. The rest pay no heed to day and night and end up crying to be held or fed. “I know a lot of people who sob over Gina Ford because it just doesn’t work for them or their baby.”

Chilton also has a book, Baby On Board, in which he warns of the effects of repeatedly leaving babies less than six months old to cry: “Without therapy or a change in their life, these babies can grow up into people who panic and fly off the handle when things aren’t going well, who are prone to depression and anxiety, and may use alcohol and other drugs in an attempt to blunt the way they feel about themselves and their world. The seeds of such life are sown in the nursery.”

Chilton bases this claim on neurobiological research. Evidence collected … shows it is during the early months after birth that crucial connections are established in the brain between the limbic system, where emotions are experienced and the neocortex, the part of the brain that rationalises experience. Babies can feel emotions but not rationalise them. If they are left to feel fear or stress, their brain releases stress hormones such as cortisol and adrenalin. If it happens in a sustained way, perhaps by parents trying to make them sleep on demand, their brains anticipate further stress as a matter of course.

Chilton acknowledges that his views may make parents even more anxious about such an enormous responsibility. It might sound sweet to “love-bomb” your baby but could you bear the guilt if you don’t? And what if your child grows up to experience depression or anxiety? Even though you tried, could you have loved him that little bit more?

At the same time he admits that the brain is highly “plastic”. “Just because you have a problem in your first year doesn’t mean you will have a problem later,” he says, the reassurologist in him returning …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Childbirth-Related Injuries Decline

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There were nearly 158,000 potentially avoidable childbirth-related injuries to women and their infants in 2006, a significant decline from 2000 …

… Between 2000 and 2006, the rate of potentially avoidable injuries during vaginal childbirth without the use of instruments, such as forceps, declined by 30%, according to the report. The injury rate declined by 21.3% for vaginal childbirth using instruments and by 16.7% for women undergoing caesarean sections.

… rates of injury were higher when instruments were used during childbirth. …trauma to the woman during vaginal delivery with the use of instruments occurred 160.5 times per 1,000 discharges, compared with 36.2 times when instruments were not used. The report said that the most common injuries to women were perineum tears, which are avoidable in many cases. Traumatic injury to infants during childbirth — such as broken collarbones, head injuries and infections — occurred 1.6 times per 1,000 discharges.

…. Women giving birth in high-income areas had 44% more injuries during vaginal delivery than their counterparts in low-income areas.

… The report found that women covered by Medicaid were less likely to be injured during childbirth — 127 injuries per 1,000 deliveries — compared with women with private insurance plans — 185 injuries per 1,000 deliveries. However, the rate of injury for infants covered under Medicaid was higher — 1.7 per 1,000 deliveries — than those under private plans — 1.5 per 1,000 deliveries.

Newborn Weights Affected By Environmental Contaminants

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Recent epidemiological studies have revealed an increase in the frequency of genital malformations in male newborns (e.g., un-descended testes) and a decrease in male fertility.

The role played by the growing presence in our environment of contaminants that reduce male hormone action could explain this phenomenon.

… the birth weight of males is higher than that of females due to the action of male hormones on the male fetus. If the exposure of pregnant women to environmental contaminants that diminish the action of male hormones has increased over the years, one would expect to see a decrease in the sex difference in birth weight.

This is exactly what a new study … shows …

… the investigators effectively show a sustained decrease in birth weight differences between boys and girls, which supports the hypothesis of growing endocrine disruption related to environmental contaminants …

“Our study underlines the importance of probing the impact of environmental contaminants on the health of mothers and fetuses and on the reproductive potential of future generations,” …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Breast-Feeding Boosts Child’s School Performance

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Children who were breast-fed do better in high school and are more likely to go to college than their bottle-fed siblings, researchers report.

… “We compare sibling pairs — one of whom was breast-fed and one of whom was not, or siblings who were breast-fed for different durations — and find consistent evidence that breast-fed children have higher high school grade point averages and a higher probability of attending college,” …

… “If you’re breast-fed, your high school GPA goes up substantially, and the likelihood that you go on to college goes up,” Rees said.

For every month you are breast-fed, your high school GPA goes up about 1 percent and your probability of going to college goes up about 2 percent, Rees added.

… “An array of health benefits is convincingly associated with breast-feeding, including a reduced risk of both infections and obesity in the breast-fed child,” Katz said. “Less certain, but long suggested, is enhanced cognitive development in breast-fed children as well.” …

Melissa Maimann, Essential Birth Consulting 0400 418 448

False Test Results Seen in Group B Strep (GBS) Screening

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A massive effort to test pregnant women for a deadly germ they can spread to their babies has yielded a bad surprise — a high rate of wrong test results that led some infants to miss out on treatment.

… the test missed more of the infections than would normally be expected. If the mothers had tested positive for the Group B strep bacteria, they would have been given antibiotics during labor to cut the chances of infecting their infants.

Group B strep is a common bacteria carried in the intestines or lower genital tract, and can be spread to babies during delivery. It’s harmless to most adults but in newborns can lead to blood infections, pneumonia, meningitis, mental retardation or hearing and vision loss, and death.

It is a rare problem which occurs in less than 1 in 3,000 births … the Centers for Disease Control and Prevention and doctor groups … recommend routine tests of all pregnant women.

No one is suggesting the screening program is a failure … infant infections from Group B strep … dipped another 27 percent.

… 250 infants out of nearly 7,700 were born with the infection … And the antibiotics seemed to be very effective …

But Schrag and others acknowledged that the false negatives were a disappointing surprise.

… the researchers calculated that they would see 44 to 86 cases of false negatives involving full-term infants. But the final study showed 116 cases — or about 60 percent of the infected full-term infants in the study were born to mothers who had been tested and mistakenly found clear of the infection.

The rest of the infected full-term babies were either not screened or were born to mothers who tested positive.

Timing may be an issue. It’s recommended [to screen women] at 35 to 37 weeks into the pregnancy … But Group B strep infections can come quickly …

The article goes on to speak of a new vaccine!!!! These days, it seems there’s a vaccine for everything.

A good point was raised by an obstetrician who mentioned that since group B strep is normal vaginal flora (present in 25% – 30% women at any given time), and since on only 1 of 400 colonized women is there a neonatal infection, the real question should be, “What is wrong with that one baby out of 400 that gets sick?”

Another aspect of care is the risk facor approach, which involves no routine screening, and offering antibiotics to women who fall into certain risk groups that are known to be associated with Group B Strep infection.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Study To Follow Pregnant Women To Better Understand Causes, Early Signs Of Autism

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NIH and the advocacy group Autism Speaks are enrolling 1,200 pregnant women who have other children with autism spectrum disorders to participate in a large study that aims to identify early signs of the condition and its possible causes … Women who participate in the study … will be monitored throughout their pregnancies, and their infants will be monitored until age three …

The study will focus on women who already have one child with an autism spectrum disorder because such women have a higher chance of having another child with the condition. … “By studying families who are already affected by autism, we feel we have the best chance at learning how genetics and environmental factors could work together to cause autism.” ….

Melissa Maimann, Essential Birth Consulting 0400 418 448

Pregnant or breastfeeding? Eat more oily fish

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… [Pregnant women] should be eating more oily fish to boost their intake of omega-3 fatty acids …

“… women in pregnancy and lactation should aim to have a regular intake of these long-chain omega-3 fatty acids that you find in oily fish … ” …

“It’s a small change in lifestyle that can major effect on long-term health,” Prof Koletzko said.

… women who had a recommended omega-3 intake during pregnancy could cut their risk of premature birth by 30 per cent.

… for “high risk” women who’d had previous premature births, their risk was reduced by 60 per cent.

A British study … also showed flow-on benefits for the child.

“If the mother had eaten more fish and seafood during pregnancy, then there was a marked advantage for IQ development until age eight years,” Prof Koletzko says.

“Fine motor development, and social behaviour, were all beneficially affected.”

Melissa Maimann, Essential Birth Consulting 0400 418 448