Posted by Melissa Maimann on Mar 4, 2010 in
Caesarean Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Link
Mums to be should only give birth by caesarean when strictly necessary, insists a new study.
Problem is, how do mothers know when the proposed caesarean is truly necessary? If they ask the doctor, “is there anything else we can do? I really want a vaginal birth”, the doctor is highly likely to say, “we’ve done everything we can do. I’m sorry. I know this is not what you wanted but the baby must come first.”. What woman would seek a second opinion?
Figures suggest caesareans carried out during labour without pressing medical reasons were 14 times more risky than a normal birth.
Data from the World Health Organisation’s global maternal survey … found pregnant women who had C-sections were more likely to die in childbirth or suffer serious complications, such as needing intensive care treatment, blood transfusion or hysterectomy.
… that women who opted for a caesarean because they believed it was merely an easier alternative to normal childbirth had been seriously misinformed.
… “Caesarean section should be done only when there is a medical indication to improve the outcome for the mother or the baby.
“Women and their carers who plan to undertake caesarean section delivery should discuss the potential risks to make an informed decision if they still wish to have a caesarean delivery.” …
Overall, the rate of Caesarean section was 27.3% …
Caesareans performed before labour without pressing medical reason were 2.7 times as risky as normal birth …
… “For those who are still inclined to consider caesarean delivery a harmless option, they need to take a cold, hard look at the evidence against unnecessary caesarean section.”
… Csections are associated with a greater risk of stillbirth and other health problems for the baby.
… children born by caesarean were 80% more likely to develop asthma by the time they were eight. Others studies have linked caesarean births to increased cases of allergies in children …
Of course, the other issue is that women who have caesareans are highly unlikely to have vaginal briths for their subsequent children. With each caesarean a woman has, the risks increase.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Caesarean, childbirth education
Posted by Melissa Maimann on Mar 2, 2010 in
Birth,
Midwifery,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
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PARENTS of a baby delivered stillborn … claim medical staff repeatedly ignored warning signs their unborn baby was distressed.
… Documents … allege a midwife ignored and turned down the volume of an echocardiogram alarm that sounded for more than three hours …
The documents also claim Mrs Body was diagnosed and treated for deep vein thrombosis and thrombophilia (blood clotting) …
She alleges the hospital ought to have known her medical history and the risks associated and failed to recognise a natural birth “could not be performed safely”.
The documents show Mrs Body was admitted to hospital at 8am on February 26, 2007, and was monitored at half-hour intervals between 9.30am and 3pm.
Her waters were broken by a doctor about 4pm and at 4.30pm an epidural was administered.
It is alleged that at 5.10pm an echocardiogram alarm attached to Mrs Body began making loud noises, but the volume was turned down by a midwife … four other times when the alarm sounded … it was turned down by the same midwife.
Monitors alarm quite often. They do not tell the midwife that the baby is distressed, they prompt the midwife to check the trace and ensure that it is ok. If the midwife determines that the baby is fine, the monitor sound is turned down.
The echocardiogram alarm continued to sound until 8.20pm but medical staff did not respond to it.
It wasn’t until 9.30pm, when Mr Body requested for Mrs Body to have an internal exam that one was performed, court documents claim.
It’s normal practice to leave 4 hours between examinations.
By 10.40pm, Mrs Body was told the baby’s heart rate was “low” and “we need to get her out now”.
This is not an uncommon scenario when a woman has had intervention in her birth. In this case, the woman had her waters broken, had an epidural and presumably also had a syntocinon infusion. All of these can stress babies. I also wonder what position she had been labouring in. It’s common for women with epidurals to labour on their backs and this does not help the baby to navigate the pelvis and be born, and it promotes fetal distress.
Paige Hannah Body was delivered by vacuum extraction about 11pm. She was not breathing and could not be revived … The State Government is yet to file a defence.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: childbirth education, Complicated pregnancy or birth, CTG, Epidural, fetal monitoring, hospital birth, intervention, midwife, Midwifery, Obstetrics, Public and private hospitals
Posted by Melissa Maimann on Feb 26, 2010 in
Birth,
Caesarean,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Link
The mortality rate of California women who die from causes directly related to pregnancy has nearly tripled in the past decade, prompting doctors to worry about the dangers of obesity in expectant mothers and about medical complications of cesarean sections.
For the past seven months, the state Department of Public Health declined to release a report outlining the trend.
California Watch spoke with investigators who wrote the report and they confirmed the most significant spike in pregnancy-related deaths since the 1930s. Although the number of deaths is relatively small, it’s more dangerous to give birth in California than it is in Kuwait or Bosnia.
“The issue is how rapidly this rate has worsened,” … “That’s what’s shocking.”
… “current trends and evidence suggest that maternal mortality rates may be increasing in the U.S.”
The alert asked doctors to consider morbid obesity, high blood pressure and diabetes, along with hemorrhaging from C-sections, as contributing factors.
… Shabbir Ahmad, a scientist … decided to look closer. He organized … a systematic review of every maternal death in California. It’s the largest state review ever conducted. The group’s initial findings provide the first strong evidence that there is a true increase in deaths – not just the number of reported deaths.
Changes in the population – obese mothers, older mothers and fertility treatments – cannot completely account for the rise in deaths in California …
… scientists have started to ask what doctors are doing differently. And, he added, it’s hard to ignore the fact that C-sections have increased 50 percent in the same decade that maternal mortality increased. The task force has found that changing clinical practice could prevent a significant number of these deaths.
… While the maternal mortality rate among black women is rising, the task force found a more dramatic increase in deaths among white, non-Hispanic mothers …
… In 1996, the maternal death rate in California was 5.6 per 100,000 live births … Between 1998 and 1999, the World Health Organization changed its coding system, which may have increased reporting of deaths. The California rate was 6.7 in 1998 and 7.7 in 1999. Because the number of mothers who die is small, the rate tends to fluctuate from year to year.
In 2003, when California revised its death certificate, the rate jumped to 14.6. And in 2006, the last year for which data is available, the rate stood at 16.9.
… When researchers unveiled their initial findings to a conference of the American College of Obstetricians and Gynecologists in 2007, there were gasps from the audience … The idea that California was moving backward even in an era of high-tech birthing was implausible to some. Confirmation of the trend was noted in the 2008 report …
The state of California has yet to share the report with the public. Researchers say that, after reviewing the report in 2008, officials in the Department of Public Health asked for technical clarifications. Revisions were complete and approved in the first half of 2009 …
… it is important for the public to be aware now that these trends are worsening …
“Even though they tend to be small numbers in terms of maternal mortality, it is important – it’s very important – that these trends be looked at,” she said. “And efforts need to be made to try and reverse them when they are going in the wrong direction.”
Rising C-section birth rate
Nearly one in three babies is now born by C-section. Many scientists have acknowledged that at some point, as the number of surgeries spiral upward, the risks will outweigh the benefits. But the C-section remains a useful tool, and in the middle of labor, doctors say, it’s hard to balance the potential long-term harm against immediate crisis.
Today, doctors face a condition called placenta accreta, where the placenta grows into the scar left by a previous C-section. In surgery, doctors must find and suture a web of twisted placental vessels snaking into the patient’s abdomen, which can hemorrhage alarming amounts of blood. Often, doctors must remove the uterus.
Main said this complication from C-sections has increased eight-to-10 fold in the past decade. Nonetheless, most women survive the ordeal … the rise in deaths is indicative of a larger problem.
“For every maternal death, there are 10 near misses; for every near miss, there are 10 severe morbidity cases (such as hysterectomy, hemorrhage, or infection), and for every severe morbidity case, there is another 10 morbidity cases related to childbirth,” …
Inducing labor before term more common
… Dr. David Lagrew … noticed that a lot of women were having their labor induced before term without a medical reason. And he knew that having an induction doubled the chances of a C-section.
So he set a rule: no elective inductions before 41 weeks of pregnancy, with only a few exceptions. As a result, Lagrew said, the operating room schedules opened up, and the hospital saw fewer babies admitted to the neonatal intensive care unit, fewer hemorrhages and fewer hysterectomies.
All this, however, came at a cost: The hospital had to take a cut in revenue for reducing the procedures it performed. Lagrew doubts that any hospital has increased its C-section rate in pursuit of profit, but he does note that the first hospitals to adopt controls on early elective inductions have been nonprofits.
According to a report issued by the advocacy group Childbirth Connection, “Six of the 10 most common procedures billed to Medicaid and to private insurers in 2005 were maternity related.” On average, a C-section brings in twice the revenue of a vaginal birth. Today, the C-section is the single most common surgical procedure performed in the United States.
“If all these guys were losing money on every C-section, well, what’s the old saying? Whenever they tell you it’s not about the money, it’s about the money,” Lagrew said.
The California task force isn’t waiting to determine the ultimate cause of these deaths. It has started pilot projects to improve the way hospitals respond to hemorrhages, to better track women’s medical conditions and to reduce inductions …
I think they’ve missed one key element: midwives! If every woman was cared for by her own midwife (and home birth and birth centre birth was encouraged as the norm for healthy women), the induction and caesarean rates would fall dramatically …. then maybe fewer women would die in childbirth.
Midwifery has an important focus on health promotion and education and would work fantastically for poorer women and women with health issues. The other priority ought to be raising the VBAC rate and reducing the number of elective repeat caesareans. Whilst the first caesarean might be safe, second and subsequent caesareans carry serious risks that are alluded to in this article.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, Birth trauma, Caesarean, childbirth education, Complicated pregnancy or birth, hospital birth, intervention, Normal Birth, Obstetrics, Public and private hospitals
Posted by Melissa Maimann on Feb 25, 2010 in
Uncategorized Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
What does an obstetrician cost in Sydney?
Fees vary greatly. As well as considering obstetrician’s fees, also consider costs such as private health insurance co-payment or excess, extra fees and charges associated with private hospital stays, paediatrician and anaesthetist fees and additional costs for ultrasounds and tests. All up, you’re looking at somewhere between $2,000 and $10,000.
Private midwifery care, on the other hand, costs somewhere between $3,000 and $6,000.
Are there any antenatal / prenatal birthing classes in the Westmead area?
Yes, this service provides antenatal classes in the Westmead area.
What is the ceasearan rate in Australia in 2009?
This won’t be known until around 2011. In 2007 it was around the 30% mark and caesarean rates have increased most years. The current caesarean rate is around 30% – 35%.
induction vs cesarean and diabetes
What about another option? What about a natural birth? Provided that there are no complications as a result of the diabetes, this might be a great option to discuss with your care provider. You might also wish to seek a second opinion with a private midwife.
Intervention in midwifery?
Midwives are experts in natural birth, and therefore tend not to intervene in births. If intervention was felt to be necessary, an obstetrician would be consulted.
natural birth in a hospital australia?
Natural birth is far more likely in a homebirth (homebirth has an average transfer rate of 25% and the births that occur at home are 100% natural). In some hospitals in Australia, natural births are around 5%. Private midwifery care dramatically increases the chance of a natural birth in any setting.
Prenatal classes sydney
Yes, this service provides antenatal classes in Sydney.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: childbirth education, continuity of care, hospital birth, midwife, Midwifery, Midwifery services, Public and private hospitals
Posted by Melissa Maimann on Feb 25, 2010 in
Birth,
Home birth,
Midwifery Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Link
For Stephanie Foley … the home birth of her son Calvin was a “peaceful, great experience.”
And while Foley said she’s pleased with how her home birth went, and that she would do it again, the issue of the safety of out-of-hospital birth is up for debate.
Statistics show that while the desire for a less sterile, more intimate birth experience is growing, most mothers in the U.S. still have their babies in a hospital. It’s the prudent choice, safer if something goes wrong, experts say.
But it isn’t a simple call.
Family history, health of the mother and fetus, available and trusted midwives and personal preference all weigh in the decision.
On average, only 1 percent of all births in the U.S. are conducted out of hospitals annually …
Tori Kropp, a perinatal registered nurse at San Francisco’s California Pacific Medical Center, says it’s safer to give birth in a hospital.
… hospital births have gotten a bad rap due, in part, to the efforts of home-birth proponents, such as TV personality Ricki Lake.
Lake’s 2008 documentary “The Business of Being Born,” ignited a fire storm by implying many common medical practices may be doing new mothers more harm than good.
Kropp has participated in 5,000 births, including that of her 9-year-old son Alexander. By participating in so many deliveries Kropp said she has “seen all the things that can happen” during what is still a potentially dangerous event in a woman’s life.
Has she been at any homebirths? It’s totally ok to have an opinion in something that one has not seen, attended, experienced or directly been a part of. But if Kropp has never been to a home birth, only obstetricially-driven hospital births, who is she to say that home is not at least as safe as hospital for healthy, low-risk women who are attended by a midwife?
“Most of the time it’s wonderful, but sometimes it’s not,” Kropp said. “At the end of the day, it’s safer to give birth in a hospital.”
Through education and outreach Kropp strives to correct what she says is “misleading” information promoted by Lake’s film. ”
“The problem with many home births,” Kropp says, is that they are performed by midwives “without the support of either physicians or a hospital.”
And is that because the midwife has not consulted with the hospital or doctor, or because they were not willing to consult when it was requested?
To spread her message, Kropp is planning a 100-hospital tour across the country beginning in Michigan on Labor Day. Kropp plans to offer free pregnancy seminars at the hospitals …
Is she planning to get her message out to women who are planning to birth at home? If so, she can talk to the hospitals all she likes, she will not reach her intended audience.
Overall Kropp’s mission is a simple one – “helping women feel empowered about the choice they make, and not the choice society wants them to make.”
But … not if they choose to birth at home. It’s ok to choose an epidural or a caesarean though!
Regardless of birth location, 8 percent of births in 2006 were performed by midwives, according to the CDC.
Definitely room for improvement there. 80% would be a great target!
When Foley gave birth to her first and only child in December 2007 she and her husband lived in a one-bedroom, second-floor apartment in Lansing.
After about 6 hours of active labor, with the help of a direct-entry midwife, Foley gave birth to her son in an inflatable pool filled with water, which is described as a water birth.
… “Pregnancy and childbirth are normal, healthy events in a woman’s life and interventions, such as cesarean sections, should be used only when medically necessary, Winkler said. “Women choose to come to the birthing center for freedom of choice.”
But Winkler cautioned that women who have chronic diseases, such as kidney disease, high blood pressure or diabetes are “safest when (giving birth) at the hospital.”
Planned home births may have a low rate of complications …
Among 13,000 planned births studied, researchers found that the mortality rate was similarly low – less than one in 1,000 – among women who gave birth at home with a midwife, women who gave birth in a hospital with a midwife, and women who gave birth in a hospital with a physician.
… “Birth is safe. It is safe to give birth out-of-hospital when a woman is healthy and having a normal pregnancy,” Winkler said.
But Kropp says even if a woman is healthy, there is still the possibility of complications in childbirth.
“Our hospital system for childbirth is so far from perfect,” Kropp said. “But someone who is completely healthy could very easily have something very unexpected happen in childbirth. Childbirth is still the No. 1 cause of death for women (worldwide), so we can’t get too cavalier in saying ‘we don’t need medical help.’”
It’s the leading cause of death for women who are not suited to home birth, such as those in third world countries who experience malnutrition, undernutrition, anaemia, bleeding in pregnancy, high blood pressure and so on. For healthy, low-risk women, the benefits of home birth are enormous.
Foley said she considered safety when making her decision to give birth at home.
“I had had no reproductive issues … for me I felt that being at home would be as safe as at the hospital,” Foley said.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, childbirth education, Complicated pregnancy or birth, continuity of care, Home birth, hospital birth, intervention, midwife, Midwifery, Midwifery services, Normal Birth, Public and private hospitals
Posted by Melissa Maimann on Feb 24, 2010 in
Birth,
Caesarean,
Normal Birth,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Link
In this world where information is so readily accessible, it never ceases to amaze me how mis-informed and ill-informed some people are when it comes to pregnancy and birth. This article is a prime example:
… As for childbirth being a natural process, yes, that is the case in most pregnancies. I know for a fact that my obstetricians don’t just let their patients go willy-nilly picking when they are tired of being pregnant or delivering babies based upon their Blackberry schedules.
Are you sure? How many caesareans and inductions are scheduled around when their husband will be home, when the doctor will be around, or the time of the year?
Have you seen the malpractice insurance premiums these guys pay? They do everything they can to keep babies and mothers alive.
There is a difference between saving a life that clearly needs to be saved, and saving a life just in case it might need to be saved at some point in the future. Intervening for the latter reason causes unnecessary harm to women and babies.
I don’t believe the majority of C-sections or early inductions are for revenue; they are for saving lives.
See above.
My child was a “complete” breech and if was not delivered via C-section, I and the child would have more than likely died during the “natural process of child delivery.”
Actually, recent research and guidelines support vaginal breech birth. It is sad that you were not informed of this.
Let’s stop C-sections or put a stigma on them and see what happens to mortality rates for mothers and babies.
If recent reports have anything to do with this, then the mortality rate will decline if caesareans reduce.
It seems that society wants a guarantee that the baby process is going to be foolproof and everyone gets the perfect “natural birth process” with no drama or sad outcome.
… it is not my right to have a natural childbirth; it is my privilege to have the best medical care in helping me achieve a healthy and safe delivery of my children.
And the best way to achieve a healthy and safe birth and baby is with a midwife. The midwife will make appropriate referrals to an obstetrician if this is needed.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, Caesarean, childbirth education, Complicated pregnancy or birth, Obstetrics
Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
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
Tags: Babies, birth, Birth choices, birth debriefing, Birth trauma, Breastfeeding, Caesarean, childbirth education, Complicated pregnancy or birth, continuity of care, Epidural, exercise, fetal monitoring, freebirth, Home birth, hospital birth, intermittent auscultation, intervention, IVF, Maternity Services Review, midwife, Midwifery, Midwifery services, Normal Birth, Nutrition, Obstetrics, postnatal depression, Preconception care, Public and private hospitals, VBAC
Posted by Melissa Maimann on Feb 18, 2010 in
Birth,
Midwifery Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
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THE cost of antenatal classes should be means-tested and made uniform across all hospitals, according to the Australian College of Midwives.
Increasingly, NSW hospitals are using private contractors to run antenatal classes because of tight budgets, which means women are being charged hundreds of dollars …
The cost varies by up to five times between hospitals.
… increasing fees were shutting some women out and the system was unfair.
… ”Antenatal education is not seen so much as core business any more so I think that’s a real problem.”
… ”Women who hold Commonwealth Health Care Cards have access to free or reduced-cost antenatal classes in many services. This decision is made on a case-by-case basis after referral from midwives, obstetricians and social workers,” he said.
Sarah Monch … attended antenatal classes at Royal Hospital for Women, which charges $270 for a six-week evening course.
Mrs Monch … thought it was not expensive and had already paid $475 for a private birth class weekend in Bowral.
”I think I got value out of both the classes and I’m glad I did them,” Mrs Monch said.
By contrast, Nicole Harris … paid $55 … at Campbelltown. ”There was so much that you learn that you don’t know.
”I wouldn’t have had a clue about anything, I would have been lost if I didn’t do that class.” …
The cost of childbirth education will rightly vary from location to location to account for differing overheads. While the cost may seem prohibitive, women do have other options to hospital classes: reading, internet, talking to friends and so on. I have always believed that the best value childbirth education is not the classes that are provided by hospitals, but the classes that are provided by independent childbith educators. These classes will not only talk through hospital policies, but also all the other options for care.
While the cost of independent classes cost may be prohibitive to some families, their brith experiences are more likely to be rated as extremely positive and the rates of intervention in the birth are lower.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, childbirth education
Posted by Melissa Maimann on Feb 8, 2010 in
Birth,
Midwifery,
Normal Birth Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Link
The use of epidurals in Ireland during labour has roughly doubled over the past 20 years. “This development isn’t a good thing. Because of the increased risk of potential complications during childbirth, administering an epidural during labour is not only undesirable — it’s also often unnecessary.”
That is the message from Dr Denis Walsh, Associate Professor of Midwifery at the University of Nottingham, who says a more naturalistic approach to labour-pain management should be considered.
… “There’s a physiological purpose to labour pain; it’s a natural state rather than a problem. So normal labour shouldn’t need to be treated as a pathology,” said Dr Walsh.
“Administering an epidural can interfere with the body’s natural responses. During labour the body releases endorphins, which not only affect the state of consciousness, but also stimulate movement. Studies have shown that walking and increased physical activity during labour can assist in the process.” An epidural, in most cases, requires that a woman remain in bed.
… Epidurals have been shown to increase the duration of labour, and cause a decrease in oxytocin. Additionally, the baby may become malpositioned to transverse or posterior.
Studies have shown a correlation between the use of epidurals and an increase in the use of forceps to aid delivery, by up to 40 per cent, and some recent research has indicated that epidural anaesthesia can lower prolactin levels in response to breastfeeding in the days following birth.
… women need to be presented with all the information regarding epidurals before undergoing anaesthesia. … “Some 50 per cent [of anaesthetists] didn’t mention the risk of intervention with forceps. The need to communicate all the risk factors is essential.
“… if a woman is in severe distress, or there are complications, of course it should be administered.
“But during a normal birth, there are other ways to make the mother more comfortable,” …
“… it’s the support given to the mother, not pain management, that’s the more significant factor in a positive experience of childbirth. Key to a positive experience is one-to-one support from a midwife.
“… One-to-one support has been shown to reduce the number of Caesareans carried out, and reduces the number of epidurals. A midwife can help in pain management both physically, for instance [with] massage, and psychologically, by offering emotional support.”
Dr Walsh suggests that access to water-immersion facilities … could reduce the need for epidurals. There is evidence to show a correlation between water immersion during the first stage of labour and a reduction in the use of epidurals …
It’s my experience that women who are well prepared for labour and who are supported in their labours with one-to-one midwifery care, do not need epidurals. A mere 3% of women who use my services choose an epidural for their labours and 80% use no pain relief at all.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, childbirth education, continuity of care, Epidural, Midwifery
Posted by Melissa Maimann on Feb 5, 2010 in
Birth,
Caesarean,
Obstetrics,
VBAC Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Link
Alice … was starved of oxygen during the final hour of her mother’s labour after doctors failed to warn her mother that there were risks associated with her second birth.
Diagnosed with spastic quadraplegic cerebral palsy, she has severely delayed mental development as well as learning difficulties and is now reliant on 24 hour care.
Her mother Carolyn had a caesarean section with her first child but doctors … did not tell her that there was a chance the womb would rupture during a normal delivery.
Lawyers for the Joyce family … claimed Alice would have been born healthy if delivered by caesarean …
… Her father … said: “Although it sounds like a large sum of money it is needed to fund Alice’s around the clock care and ensure she gets as much out of life as her disabilities allow.
… A court ruling today is expected to award Alice a lump sum payment of £2,250,000 plus annual payments until she is 16 of £95,000 pounds and £185,000 after that for the rest of her life.
The case was funded through legal aid, without which the family would not have been able to afford legal costs to prove negligence or the experts needed to prove her complex needs.
… Chief nurse and director of patient care standards Sarah Watson-Fisher said: “We would like to express our sincere apologies to Alice and her family for the errors in the care given at the time of her birth …
“We take matters like this very seriously and are committed to learning from our mistakes. We hope that the settlement will be of great assistance to Alice and we offer her and her family our best wishes for the future.”
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, Caesarean, childbirth education, Complicated pregnancy or birth, hospital birth, Normal Birth, Obstetrics, Public and private hospitals, VBAC