Posted by Melissa Maimann on Jul 22, 2010 in
Birth 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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Children conceived using in vitro fertilization (IVF) appear to have a moderately elevated risk of cancer — although the absolute risk remains low …
Among the 26,692 children studied who were conceived by IVF between 1982 and 2005, after adjusting for year of birth, the estimated odds ratio for cancer risk was 1.42 (95% CI 1.09 to 1.87, P=0.01) compared with children who were not conceived via IVF …
… however, IVF itself may not be responsible …
The reason for the increased risk could be a higher rate of preterm birth and neonatal asphyxia among these children or because of unidentified characteristics of the women who undergo the procedure …
… While mothers who used IVF to conceive had a variety of characteristics that differed from other women, including older age and increased rates of multiple pregnancies, none of these were significantly linked with the elevated cancer risk seen in their children.
… several characteristics of the children did appear to play a role.
After adjustment for year of birth, significantly increased risk for cancer in the entire population was associated with preterm birth before week 37 (odds ratio 1.16), for birth weight of 4,500 g (9.9 lbs) or more (OR 1.21), for large-for-gestational-age birth (OR 1.34), and for low Apgar score (OR 1.33).
The only one of the factors more common among IVF children than among others in the general population was a low Apgar score …
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Complicated pregnancy or birth, IVF
Posted by Melissa Maimann on Jun 4, 2010 in
Birth 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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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
Tags: Babies, Complicated pregnancy or birth, IVF, Preconception care
Posted by Melissa Maimann on Apr 17, 2010 in
Birth,
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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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
Tags: Babies, birth, Complicated pregnancy or birth, IVF, Public and private hospitals
Posted by Melissa Maimann on Feb 28, 2010 in
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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Endometriosis affects 10 percent of women of reproductive age, yet the condition remains one of the most neglected and underfunded fields of research in gynecology …
… the statistical association between endometriosis and infertility is beyond dispute. One well-cited study found a higher prevalence of endometriosis in infertile women (48 percent) than in fertile women undergoing tubal sterilization (5 percent) … infertile women are 6-8 times more likely to have endometriosis than fertile women.
… a new diagnostic staging tool has been proposed that predicts the chance of spontaneous pregnancy in those with surgically documented endometriosis who are treated without IVF … The EFI score ranges from 0-10, with 0 representing the poorest prognosis and 10 the best … those patients with scores of 0-3 could expect a cumulative pregnancy rate of 11.1 percent at 3 years, increasing to 68.3 percent for those with scores of 9-10.
… the most common symptoms of endometriosis were painful menstruation, painful intercourse, and incapacitating pain …
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Complicated pregnancy or birth, IVF, Obstetrics, Preconception care
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 Jan 30, 2010 in
Birth,
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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The widespread use of … fertility drugs, not just high-tech laboratory procedures, likely plays a larger role than previously realized in the growing problem of premature births in the United States, because these drugs cause a high percentage of multiple births …
… controlled ovarian hyperstimulation (COH) drugs — used to stimulate a woman’s ovaries to speed the maturity and multiply the production of eggs — accounts for four times more live births than assisted reproductive technologies (ARTs) such as in vitro fertilization.
“Many people have focused on the role of ARTs in multiples and have not fully appreciated that fertility drugs alone are responsible for one out of every five multiple births,” … “COH drugs are widely prescribed, and some health care professionals … are not aware of the serious risks of fertility drugs to women and their babies. There is a very high possibility of multi-fetal pregnancy resulting from use of these drugs, and that brings a high risk of prematurity and lifelong health problems for the babies as a consequence.”
… About 60 percent of twins, more than 90 percent of triplets, and virtually all quadruplets and higher-order multiples are born prematurely … studies have also suggested that even infants born singly, but conceived with ovulation stimulation are at increased risk for preterm delivery than naturally conceived single births …
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Complicated pregnancy or birth, IVF, Obstetrics, Preconception care
Posted by Melissa Maimann on Dec 1, 2009 in
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email me or call 0400 418 448.
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… A new study has found a higher rate of birth defects among babies conceived by assisted reproduction compared to babies conceived naturally.
… almost 3 percent of infants conceived with assisted reproduction were diagnosed with a major birth defect, compared to less than 2 percent of babies conceived naturally …
… 3.45 percent of those born via IVF had major birth defects.
… One contributing factor could be the greater age of mothers… who undergo this treatment …
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Complicated pregnancy or birth, IVF, Obstetrics, Public and private hospitals
Posted by Melissa Maimann on Oct 26, 2009 in
Birth,
Normal Birth,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email me or call 0400 418 448.
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… obesity cuts the chance of IVF working and increases the risk of premature birth and stillbirth.
… [the] impact becomes more profound as weight increases …
… being overweight and obese affects natural conception too and has a profound impact on a woman and her baby’s health throughout pregnancy and beyond.
… the most obese women … had 35% less chance of falling pregnant and a 59% increased chance of giving birth to a very premature baby …
… “The take-home message … is that women need to reduce their weight before trying fertility treatment.
… “Obesity is a state of inflammation and … It is not conducive to conception and … pregnancy.”
… 32% of women over 16 are overweight … and 21% … are obese …
… being overweight increases the risk of diabetes during and after pregnancy, pre-eclampsia and developing a potentially lethal DVT.
… the chances of recognising foetal abnormalities decrease in overweight and obese women because the quality of ultrasound images falls.
… “Just … losing 5% of their body weight may be enough to restore ovulation in women who are overweight.”
… “Women need to understand that obesity cannot only affect themselves – it can affect their child. If the mother is obese, their child is three times more likely to be obese; and if the father is obese too the child is eight times more likely to be obese.”
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Complicated pregnancy or birth, exercise, intervention, IVF, Nutrition, Preconception care
Posted by Melissa Maimann on Aug 30, 2009 in
Birth,
Obstetrics For further information, contact Melissa Maimann at Essential Birth Consulting.
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The common belief is that it won’t hurt to try alternative fertility treatments before reverting to … IVF. But a new study from Denmark finds that the success of IVF treatment is 30% lower among women who have used alternative medicine … Women who had first tried … reflexology, acupuncture, or herbal- and aroma therapy, had significantly lower pregnancy rates after IVF treatment.
… Whether the effect on IVF success is a direct result of the use of complementary medicine, or whether women who were already having more trouble conceiving were more likely to revert to alternative fertility treatments could not be determined …
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: IVF
Posted by Melissa Maimann on Aug 24, 2009 in
Obstetrics For further information, contact Melissa Maimann at Essential Birth Consulting.
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Australian families who seek specialist obstetric care during pregnancy will up to $1,830 worse off if the Australian Government does not reconsider its proposed cuts to Medicare payments before the Senate this week.
It doesn’t seem to concern NASOG that Australian families are up to $5,000 “worse off” for seeking private midwifery care. Private midwifery has never been afforded medicare benefits, despite much research that supports the role of the midwife for most women.
… Dr Hilary Joyce, President of the National Association of Specialist Obstetricians and Gynaecologists (NASOG), warned that under the Bill going before the Senate this week, all patients embarking on having a family will be worse off when they go to see their specialist obstetrician.
“All couples who undertake fertility treatments and then who need special obstetric care throughout their pregnancy will be hit harder still with the double financial whammy of fertility treatment and maternity treatment cuts to Medicare,”
I’m not clear why Hilary believes that women who have fallen pregnant through ART require ongoing obstetric care. She has made a statement without backing it up by research. I’d like to read the research that states that this is so. While pregnancies that have been achieved through ART may have risks associated with them, that is also true of every pregnancy. No pregnancy is risk-free. There’s no reason not to have midwifery care pre-emtively. If complications are detected or even suspected, the midwife will make a referral to a hospital or obstetrician, and the woman will receive appropriate care.
“We are concerned about the families who won’t be able to afford the choice of their own obstetrician because of these proposed Medicare cuts. … Will they be forced into the already overwhelmed public hospital system? …
The proposed changes prevent women from accessing the midwife of their choice. Hilary does not seem to be concerned by this. These women will also be forced into the overwhelmed public system.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Complicated pregnancy or birth, hospital birth, intervention, IVF, Maternity Services Review, Obstetrics, Public and private hospitals
