Monday, December 31, 2007

Top 5 Most Under Reported Birth Stories of 2007

Top 5 Most Under reported Birth Stories of 2007-


O.K. So it is U.S. stuff but I have added some Canadian comparisons....Can you find more?


Following the lead of Time.com’s “Top 10 Most Under reported Stories of 2007” I thought we could take a look at our country’s top 5 most under reported birth stories of 2007. So, here it is:


Top 5 Most Under reported Birth Stories of 2007


A year-end review brought to you by www.nowombpods.blogspot.com(US content) and
www.birthrhythms.blogspot.com (Canadian content)

5. An Orlando mother goes into hospital to give birth and leaves without her arms or legs.

(http://www.wftv.com/news/6253589/detail.html)

The birth for this mother was smooth. It’s what happened afterwards that left her unable to hold or care for her newborn. Claudia Mejia went into a hospital to give birth but when she left the hospital, her arms and legs stayed behind. She is now a quadruple amputee and the hospital refuses to tell her why. She was told she had streptococcus and toxic shock syndrome but the hospital will not tell her how she contracted them. It is unlikely Ms. Mejia would have contracted the illnesses had her baby been born at home.
5.b. Canadian Doctor not negligent in case where woman lost limbs: jury
Last Updated: Wednesday, November 28, 2007 | 5:15 PM CT
CBC News
The Saskatchewan surgeon who operated on a woman who later went into septic shock and needed to have her hands and feet amputated did not act negligently, a Saskatoon jury has decided...more
What the article doesn't tells you is that the procedure was done following the birth of her child before her discharge from hospital. Unfortunately I cannot find a web source for you to support that fact. Does anyone else have something that could substantiate it?

4. a. A Florida woman dies following induction of labor.

(http://www.sptimes.com/2007/05/19/news_pf/Tampabay/Why_she_died_a_puzzle.shtml)

Caroline Wiren was a young, healthy mother who was excited by the upcoming birth of her child. She touched his head, told her mother to tell the baby that she loved him, and then she was gone. Mrs. Wiren had her labor induced just seven days past her baby’s due date, even though it is common for a woman’s first child to be born as much as two weeks after the given due date.

According to http://www.medpagetoday.com/OBGYN/Pregnancy/dh/4334, one possible complication of induction of labor is amniotic-fluid embolism, which can lead to death.

4. b. In Canada, the Society of Obstetricians recommends "counselling women" who reach 41 weeks of the "higher risks of expectant management". Two Canadian obstetricians from the University of Manitoba have written a swingeing article published in the British Journal of Obstetrics and Gynaecology criticising this policy1...They conclude: "The higher risk that routine induction at 41 weeks aims to reduce is dubious, if it exists at all."

Most women who have not given birth by 41 weeks will have gone into labour by 42 weeks. One study showed that 19 per cent had not had their babies by 41 weeks, but only 3.5 per cent were still pregnant at 42 weeks.

Following the Canadian policy, in a hospital with 4000 births a year, about 1000 inductions would be done solely because the mother had reached 41 weeks. The authors point out that the extra attention given to those being unnecessarily induced could reduce the care available for inductions carried out for urgent medical reasons. They cite the case of a woman with severe hypertension whose induction was delayed because the labour floor was filled with 41-week inductions. The mother died of intracranial haemorrhage. more
Amniotic-Fluid Embolism and Medical Induction of Labor: A Retrospective, Population-Based Cohort Study.

Obstetrics
Obstetrical & Gynecological Survey. 62(4):219-220, April 2007.
Kramer, Michael S.; Rouleau, Jocelyn; Baskett, Thomas F.; Joseph, K S.; for the Maternal Health Study Group of the Canadian Perinatal Surveillance System

Abstract:
Amniotic-fluid embolism is a rare complication of delivery, the cause of which is unknown. It remains one of the major causes of maternal deaths in developed countries. This population-based cohort study sought to clarify the association between amniotic-fluid embolism and medical induction of labor in a cohort of 3 million hospital deliveries taking place in several regions of Canada in the years 1991-2002....Of 180 affected singleton births, 24 were followed by the mother's death, for a case-fatality rate of 13%. There was no apparent increase over time in amniotic-fluid embolism for either total cases or fatal cases. Medicalinduction of labor nearly doubled the risk of amniotic-fluid embolism...more

3. a. Two New Jersey women die just days apart following their cesarean surgeries.

http://www.nownj.org/njnews/2007/0518%20Moms%20decry%20high%20N.J.%20C-section%20rate.htm

Two young, healthy mothers entered a hospital in New Jersey to give birth to their babies. Both had cesareans and both were dead within days. The mothers leave behind two beautiful, absolutely healthy baby girls. This raises the question: then why the surgery?

3. b. Canadian news... Increased risks of planned cesarean births must be clearly conveyed

February 13, 2007 - A three-fold rate of severe complications overall is reported among women having a planned cesarean section compared with those who planned a vaginal delivery. Liu and colleagues studied women who delivered a child between 1991 and 2005 in Canada (excluding Quebec and Manitoba). The rate of severe complications in 46,766 healthy women who had a non-urgent cesarean delivery for a breech baby was compared with that among 2,292,420 healthy women who delivered (non-breech) babies vaginally. The rate of severe complications (such as major infection and blood clots) in the planned cesarean group was found to be 27.3 per 1000 deliveries, compared with 9.0 per 1000 deliveries in the planned vaginal delivery group.

Because breech babies are at greater risk during vaginal birth, breech position is an accepted medical indication for planned cesarean birth. This may not hold true for non-breech babies, however, and the authors express concern about the growing number of women who request delivery by cesarean section without an accepted medical indication.

In a related commentary, Armson notes that in Canada, the cesarean birth rate has increased from 5.2% in 1969 to 25.6% in 2003. He reviews the complex interplay of obstetric and nonobstetric factors that contribute to this trend.

Canadian Medical Association Journal
http://www.brightsurf.com/news/headlines/28821/Increased_risks_of_planned_cesarean_births_must_be_clearly_conveyed.html

...The risk of postpartum death was 3.6 times higher after cesarean than after vaginal delivery (odds ratio 3.64, 95% confidence interval 2.15–6.19). Both prepartum and intrapartum cesarean delivery were associated with a significantly increased risk. Cesarean delivery was associated with a significantly increased risk of maternal death. more from the Canadian Post-Partum Maternal Mortality and Cesarean Delivery
Obstetrics and Gynecology, Vol. 108, Issue 3, September 2006


2. a. The most updated birth data from the CDC shows that the cesarean rate in the United States has risen to 31.1%.

(http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_07.pdf)

This latest number (from 2006) represents a 10.4% increase from ten years ago, and a 3% increase from the previous year. The report also indicates that the percentage of low birthweight babies and preterm babies is on the rise. Consumer Reports names the cesarean as one of the 10 most overused tests and treatments (http://www.consumerreports.org/cro/health-fitness/health-care/medical-ripoffs-11-07/10-overused-tests-and-treatments/medical-ripoffs-ten-over_1.htm).

2.b.Canada's Caesarean Rate at Record High;Millions spent on preventable surgeries
http://www.sources.com/Releases/ICAN01-CaesareanRate.htm

The number of caesarean sections in Canada is again at a record high, reports the Canadian Institute for Health Information (CIHI) in their 2007 Health Indicators report. Consumer health groups are concerned. "Everything we know about caesareans supports reducing the number for this major surgery," says Connie Thompson, President of the International Caesarean Awareness Network in Canada (ICAN Canada).

In Canada, 26.3% of women delivered babies by caesarean in 2005 - 2006, increased from 25.6% in 2004 - 2005. However, there was huge variation between health regions (17.8% to 36.8%), and provinces and territories (8.2% to 30.4%). Common reasons given to justify the rise in caesarean sections are that women are having children later in life, thus increasing pregnancy risk and the chance of birth complications, or that women are choosing to have caesareans for personal convenience. None of these factors explain the wide variation in caesarean rates across Canada.

"Medically unnecessary caesareans happen every day," says Ruth Wadley, a mother of 3 in Edmonton. "I was told by my OB that if I showed up at the hospital I would be sectioned." Ms. Wadley delivered her first two children by caesarean and was planning a VBAC for her third last month. "I was given a zero percent chance of ever giving birth naturally but I felt I deserved the opportunity to try," Ruth explains. "I hired a professional midwife and had a perfectly normal birth at home."

The report also states, "Since unnecessary caesarean section delivery increases maternal morbidity and mortality and is associated with higher costs, caesarean section rates are often used to monitor clinical practices with an implicit assumption that lower rates indicate more appropriate, as well as more efficient, care." The World Health Organization (WHO) states that a rate over 10-15% means that unnecessary caesareans are being done.

The report "Giving Birth in Canada: The Costs" from CIHI last year gave the cost of a caesarean as $6000 ($4600 for woman plus $1400 for baby), compared with $3600 ($2800 for woman plus $800 for baby) for a normal birth. With over 343,000 births in Canada in 2006, if WHO guidelines were followed, over $93 million could be saved.

"Put the two together," says Connie Thompson, "and it is clear that many of the caesareans being done in Canada are preventable, risk the health of mother and baby, and cost millions of dollars for our overstretched healthcare system. It is time for a change."

For more information on cesarean awareness and prevention, please visit www.ican-online.org

1.a. United States ranks among lowest of developed nations in terms of newborn death rates. (http://www.cnn.com/2006/HEALTH/parenting/05/08/mothers.index/index.html)

1.b. Canada also ranks in bottom half of developed nations in terms of newborn death rates. check out this link: (10 worst and best)

According to Save the Children researchers, infants in the United States are more than three times as likely to die within their first 24 hours as infants in born in Japan. The United States has the second highest IMR (infant mortality rate) in the developed world, Canada shares the third worst record with 11 other countries. Latvia is the only developed country with a higher IMR than the U.S. There are 22 countries in the world where it is safer to give birth than Canada. see more

That being said let's try to end on a positive note; "With the exception of Japan, Canada has had the most dramatic decline in infant mortality rates in the past 35 years. In 1996, the infant mortality rate in Canada was 5.6 per 1,000 live births compared with a rate of 27.3 per 1,000 live births in 1960; it has decreased steadily since the early 1960s, tapering off somewhat in the mid-1980s." see more...

Definition of Midwife

Definition of Midwife from Midwifery Today

A midwife is a primary health care provider whose services are guided by the individual needs of each mother and baby. Her abilities and knowledge are the health, physiology and effective care of pregnancy, birth and postpartum.

She acts in a humane, receptive and flexible manner. She is willing to update her knowledge continually while maintaining a practice of meticulous care with minimum intervention.

She acquires essential knowledge from other midwives through a variety of educational routes within a formal or traditional process, as well as by assisting with mothers and babies.

A midwife shares information with mothers, families and the community that may include her model of care, alternative health services, rights and responsibilities, wellness, preventive care, bonding, breastfeeding, child rearing and family planning.

A midwife provides care and oversees the health of women and their babies during the childbearing year and assists with birth. She may provide lifelong care to women. The midwife's practice is autonomous: she may offer her services at clinical facilities and in homes.

A midwife can identify health problems, knows techniques for managing emergency situations and has a plan to refer or transport, when necessary.

A midwife is acknowledged as a primary provider of maternal health services by the members of her community or by the country in which she practices.

Tuesday, December 25, 2007

CBC News

The majority of new Canadian mothers are happy with their labour and the birth of their child, suggests new data released Tuesday by Statistics Canada, though midwife deliveries are seen in a more positive light.

http://www.cbc.ca/health/story/2007/11/27/statscan-babies.html

Wednesday, December 19, 2007

Why is there a need for Doulas in Saskatchewan?

As childbirth has moved from home to hospital, a vital element of care has been lost from the whole process. Gone are the days where a woman would have continuous support from one caregiver throughout her labour.

It used to be the case that the womenfolk within the immediate and extended family (mothers/sisters/grandmother etc...) would be on hand to provide the nurturing role for the new mother, to guide by experience and help with the practicalities that need to be performed before, during and after a woman gives birth to a baby.


The concept of the community midwife is only now being developed in Saskatchewan, but due to the immediate lack of resources, (midwives and willing Health Districts) this service will not be readily available to all women for perhaps another decade or more. Doulas fill this gap in services, by supporting women in the birth environment of their choice.


Presently, many women feel that they have no choice but to be in hospital to give birth to their baby where it is much more likely that a birth will be medically managed and intervention methods will be used.


RESEARCH has shown that having a Doula present at a birth ;
Shortens first-time labour by an average of 2 hours
Decreases the chance of caesarean section by 50%
Decreases the need for pain medication
Helps fathers participate with confidence
Increases success in breastfeeding.....

Reference: "Mothering the Mother,"
Klaus, Kennell & Klaus, 1993
A doula believes in “mothering the mother”


.....enabling a woman to have the most satisfying and empowered time that she can during pregnancy, birth and the early days as a new mum. This type of support also helps the whole family to relax and enjoy the experience.


Birth doulas are trained and experienced in childbirth, although they may or may not have given birth themselves. They have a good knowledge and awareness of female physiology BUT the Doula is not supporting the mother in a clinical role - that is the job of the midwife/medical staff.

Postnatal doulas work flexible hours to suit the family, offering practical and emotional support to the new mother and father in the home following the birth of baby. In the West today, too often mothers are rushed back into normal day-to-day activities; in many cultures women are confined to bed and rest for a period of up to 40 days.

This may be impossible in our society but with the help of a postnatal Doula, a mother can enjoy some of the benefits of a prolonged "lying in" period. This will help her bond with her baby and spend extra time with any older siblings. Our work is about empowering a family to take care of itself and we facilitate this by helping around the house and offering encouragement and suggestions.

Tuesday, December 18, 2007

Estimation of Fetal Weight



In the case of macrosomic fetuses, attempts to predict birth weight
from fetal measurements on ultrasonography have been unsuccessful in
improving clinical outcomes. Many researchers have concluded that
ultrasonographic fetal biometric assessments are no more predictive of
fetal macrosomia than clinical assessments of fetal size by means of
simple external abdominal palpation. More...

Thursday, December 06, 2007

New Canadian Book Review!

Pregnancy and Childbirth Secrets; by Gail Dahl


I have been using this book on trial as a text in my prenatal education class. It is a great hit with all of the moms!! Well written with firm reseach to BACK UP RECOMMENDATIONS...CHECK OUT THIS ARTICLE ABOUT IT: Gail Dahl