ARTICLES ON WOMEN’S AND CHILDREN’S HEALTH
Bat Midwife|Birth|Breastfeeding|Breech|Cesarean|Centering Pregnancy|Epidurals|
BAT MIDWIFE ARTICLE
1) Bat Midwife Aids Mother to Be
Boston University biologist Thomas Kuntz observed the behavior of Rodrigues fruit bats where “a female struggling with a difficult birth, [was] assisted for three hours by a female helper.” Bat Midwives?? Kuntz made the discovery by chance at a lab in Florida, one of twelve captive breeding facilities for Rodrigues fruit bats. In the wild, there are only 350 of these bats left, due to deforestation, and they are found only on Rodriguez Island in the Indian Ocean. National Geographic says “Although bats usually give birth in a head up, feet down position, this female was laboring to do so head down. Another female approached her and repeatedly assumed the correct position, imitating contractions and straining. Finally the mother caught on, and a wing and a foot emerged in a breech birth-a successful one.” If bats can do it, why can’t we?
1997 National Geographic, Earth Almanac
Original Artwork Copyright © 1998 Paul Girard
THE BUSINESS OF BEING BORN ARTICLES
1) “The Business of Being Born” -Rikki Lake and Abby Epstein’s Film
Ricki Lake’s valentine to the home-birth movement.
By Dana Stevens
Posted Friday, Jan. 11, 2008, at 6:07 PM ET
The Business of Being Born, a documentary directed by Abby Epstein and produced by talk-show host Ricki Lake, is a generous-spirited tribute to the practice of home birth. It’s full of moving (and surprisingly ungross) filmed deliveries, including those by Epstein and Lake themselves. Unfortunately, the movie is also a propagandistic brief on behalf of the home-birth movement that’s so selective in its presentation of information that it makes Michael Moore look like a fat lady in a blindfold holding a pair of scales.
2) Rikki Lake and Abby Epstein’s Film on Birth In America
3) An Interview with Cara Muhlhahn /Interview_with_Cara_Muhlhahn.cfm#emergency
ACNM Talks with Cara Muhlhahn, CNM, Midwife Featured in The Business
of Being Born, Rikki Lake and Abby Epstein’s Film on Birth In America
Click here for more on The Emergency Transfer Scene: What the Cameras
don’t Show An American College of Nurse Midwives www.acnm.org member featured in Rikki Lake’s new birth documentary talks about the film and shares her personal calling to midwifery.http://www.thebusinessofbeingborn.com
1) The Problem with Breastfeeding
By Jeannie Babb Taylor, On the Other Hand
What if doctors discovered a substance so potent, it could prevent dozens of diseases and even reduce the risk of cancer? What if these benefits extended not only to those who partake of this amazing substance, but also those who serve it? If a pharmaceutical company had developed it, it would be a billion-dollar industry. Breast milk, though, is free. Without a visible profit stream, it also lacks a marketing team.
Numerous studies show that breastfeeding reduces cancer risks for both givers and receivers — yet the American Cancer Society (ACS) has no campaign statement on the importance of breastfeeding. One huge study (147,000 participants) found that American women could cut their breast cancer risk by 33% by increasing the lifetime average of breastfeeding from three months to thirty months, which is the worldwide average. The ACS concluded that significantly increasing breastfeeding duration was “unrealistic” and instead continues to focus on mammograms, cancer prevention drugs and other methods that put money in the pockets of physician groups and pharmaceutical companies.
Although breastfeeding has been shown to reduce sudden infant death syndrome (SIDS) risk by as much as 55%, the National Institute for Child Health (NICH) invests virtually nothing in breastfeeding education. Instead, the NICH organized the “Back to Sleep” campaign encouraging parents to put babies to bed on their backs. The first corporate sponsor of the Back to Sleep campaign was Gerber, a formula and baby food manufacturer. Is it any surprise there is no financial backing to promote breastfeeding as a SIDS prevention tool?
Breastfeeding contributes significantly to child health. According to the American Academy of Pediatrics (AAP) breastfeeding is “as important to preventive pediatric health care as promoting immunizations, car seat use, and proper infant sleep position.” Yet a recent AAP survey found that 45 percent of pediatricians who responded see formula-feeding and breast-feeding as equally acceptable. Once again, we can follow the money to understand this phenomenon. Doctors receive numerous samples, perks, and gifts from formula companies — a practice condemned by the World Health Organization (WHO.)
Formula makers are forced to give lip service to the superiority of breastfeeding. Yet these companies spend millions of dollars per year tripping up new mothers. They have inroads at the obstetrician’s office, the hospitals where babies are born, and the pediatrician’s office. Formula makers ensure that every mother goes home with a couple of cans of formula, so it will be available in the middle of the night when the baby is crying, she is exhausted from lack of sleep and she is vulnerable to the insecurities American society has pressed on her day after day. The result? Even though 70% of mothers start breastfeeding, within a few months the statistics have flipped. Only 11.3% of babies are still exclusively breastfed at six months.
It is difficult to blame American mothers for the failure to breastfeed, when everything is stacked against mothers from the start. Unlike women in most other developed countries, American women receive no paid maternity leave. Only those on welfare receive a stipend to carry them through the first months of mothering. Women who support themselves are forced to return to work, where it is often impossible to bring an infant, and pumping opportunities may be few and far between, with unsanitary conditions.
Rep Carolyn Maloney (D-NY) recently introduced the Breastfeeding Promotion Act of 2007. The bill amends the Civil Rights Act of 1964 to protect breastfeeding women from workplace discrimination. It also gives employers a tax credit of up to $10,000 per year to provide employees with equipment, dedicated space and consultation for pumping breast milk. The bill establishes standards for breast pumps, and creates tax breaks for women who purchase breast pumps in order to maintain employment.
Maloney says, “I have heard many horror stories of women who were fired for trying to figure out a way to express milk at work. My bill clarifies the Pregnancy Discrimination Act to protect breastfeeding under federal civil rights law, ensuring that women cannot be fired or discriminated against in the workplace for expressing (pumping) milk, or breastfeeding during breaks or lunch time.”
At least the welfare moms have the chance to stay home and breastfeed — after all, their babies comprise the most high-risk population of infants in terms of health problems, asthma, failure to thrive and learning disabilities. Yet the formula-makers find these mothers, too. Government programs take away one of the incentives for breastfeeding by shelling out $600 million per year to put low-income infants on the bottle. Taxpayers also foot the bill for the increased healthcare cost of these children.
The U.S. government has certainly been slow to recognize the fountain of youth. Reagan and the first Bush both refused to ratify the World Health Organization’s breastfeeding code, designed to protect new mothers from formula makers’ guerilla marketing tactics. The code was not recognized by the U.S. until Clinton signed it in 1994, and it is still not enforced.
Recently, a handful of individual states sought to enforce the code. They especially want to stop hospital formula marketing, because once a baby receives a bottle, the mother and baby are confronted with a whole host of problems including nipple confusion and inadequate milk supply. If successful breastfeeding is not established within the first few days, formula-makers are practically guaranteed a new customer.
In Massachusetts, it was Governor Mitt Romney who struck down a ban on hospital marketing. Less than two weeks later, Romney announced that he had secured the construction of a $66 million pharmaceutical plant in Devens, Massachusetts. The plant is owned by Bristol-Myers Squibb, the largest formula manufacturer in the world.
Outside the U.S., things are no better. Nestle actually targets babies in developing countries, where breastfeeding has the greatest potential for good. Babies are routinely hooked on formula in third world hospitals and sent home without ever establishing breastfeeding. Back in the village, families soon discover that the cost of buying formula is higher than their entire wage.
As a result of Nestle’s tactics, sub-Saharan Africa has a breastfeeding rate of only 32%; Asia, 35%; Indonesia, 39%, Vietnam, 19%, and Thailand, 5%. According to WHO and UNICEF, approximately 1.5 million babies die each year because they were started on formula instead of breast milk.
American women who breastfeed should expect resistance from a society that depicts over-sized breasts on magazine covers and billboards, yet rejects the breast’s highest function. Numerous polls show that the majority of Americans are comfortable seeing women breastfeed in public; yet, a few shrill voices continue to insist that it is improper.
American women have been harassed or thrown out of libraries, restaurants and public parks for the simple act of breastfeeding. One woman was even expelled from a Vermont Delta Freedom flight for breastfeeding her child, resulting in nurse-ins at Delta counters across the nation.
Most recently, comedian Bill Maher praised Appleby’s for discriminating against a nursing mother, asserting that women who breastfeed in public are lazy and narcissistic. Maher’s other comments, which are too crude to be printed in the county paper, illustrate that what bothers some people about breastfeeding isn’t that it is perceived as sexual, but rather that it is not. Hooters, wet T-shirt contests and Playboy magazines are just fine with people like Maher, who believe that breasts are not for babies, but for men.
Although doctors agree that “breast is best,” their own licensing board does not follow their recommendations. Breastfeeding mother and aspiring doctor Sophie Currier had to sue the National Board of Medical Examiners for the right to take pumping breaks during her nine-hour licensing exam. In typical anti-feminist fashion, the judge told Sophie she would just have to take the exam when her child was older and finished breastfeeding. She would have lost her residency in clinical pathology at Massachusetts General Hospital and derailed her career. Sophie appealed the decision, and won.
The “problem” with breastfeeding is that it lacks a corporate profit stream. It profits mothers and babies tremendously. It profits families, the government and taxpayers. The USDA estimates that $3.6 million in healthcare costs could be saved if more U.S. babies were breastfed. Unfortunately, nothing much happens in America unless it lines the pocket of a corporation. WHO cares about breastfeeding, but corporate America never will.
We live in a culture that despises human bodily fluids — even as we feed our children cow’s milk and use pregnant mare urine (Premarin) to balance menopausal hormones. Canadian researchers are even developing medicines based on genetically-engineered pig semen. The market for animal fluids continues to grow, because there is a profit stream associated with it. If formula companies maintain control of doctors and legislators, a day may come when humans are no longer classified as mammals. Mammals, after all, are defined as animals that have hair and suckle their young.
About the Author
Jeannie Babb Taylor is a local business leader and author. She also teaches Sunday school, educates her children at home, and engages in Georgia politics. Jeannie may be contacted at firstname.lastname@example.org, or you can leave a public comment on her blog OntheOtherHandColumn.blogspot.com
2) Breastfeeding and IQ: Rooting for Intelligence
New evidence suggests that breastfeeding may make babies smarter. Researchers have found small increases in cognitive development in breastfed babies when compared to bottle-fed babies. Using various measurements, including standard infant testing and even report cards, give a statistically significant higher measure of intellegence in babies that nursed.
In a 1992 study by Alan Lucas of the Dunn Nutrition Unit in Cambridge, Mass., preemies who were tube-fed breast milk scored much higher on developmental tests than babies who were tube-fed artificial baby milk.
Although the research is showing that breasfed babies are smarter, according to the sources quoted in the Newsweek article, no one is about to come out and say so.
Researchers still cannot say why breastmilk is so fortifying for the human brain. “The precise mix of enzymes, long-chain fatty acids and proteins that make up breast milk is so complex that no human engineer could ever successfully duplicate it. And each ingredient has a purpose. Specific fatty acids found in breast milk have been shown to be critical for neurological development. Certain amino acids are a central component for the development of the retina, which could account for breast-fed babies’ increased visual acuity – another way of measuring advanced brain development.”
Critics of the research say that the developmental advantages of breast-feeding are hard to pin down, as there are so many variables contributing to cognitive development of children, including “race, age, socioeconomic status and parental intelligence. ”
Even the manufacturers of artificial baby milk acknowledge that their products can’t match the complexity of human breast milk, even with added amino and fatty acids.
Breast-feeding advocates will certainly capitalize on the latest studies to promote breastfeeding. While skeptics of the studies on the other hand, will suggest that different factors, like loving treatment by it’s caregivers, may ultimately prove to be more important than what a child is fed. As quoted in The Newsweek article, a 1996 commentary in the British journal Lancet, William and Mark Feldman of the Hospital for Sick Children in Toronto wrote: “The best evidence is that intelligent, loving and caring mothers are more likely to have intelligent children, irrespective of how they feed their babies.” Whether or not intelligence ends up being added to the list of benefits of breastfeeding or not, there remain many good reasons to breastfeed, for the health of the baby and the mother.
3) Milkmen: Lactation in Males
This article discusses lactation in men…it is very interesting:
BREECH BIRTH ARTICLES
1) Planned Cesarean Surgery Is No Safer for Breech Births
Despite one study’s conclusion that planned cesarean surgery results in superior outcomes for babies and equivalent outcomes for mothers, flaws in this research indicate otherwise. In “When Research is Flawed,” obstetric research expert Henci Goer finds several problems in how the Hannah study—a randomized trial to compare planned cesarean surgery vs. planned vaginal birth for breech births was conducted and its interpretations of the results. Other studies, based on a good selection of patients, contradict these findings and report that with a good selection of patients, properly trained medical staff and careful management during labor, vaginal birth is safe for breech babies.
“When Research is Flawed,” developed by the Lamaze Institute for Normal Birth, provides brief critiques of some of the most influential research studies published on topics that shape and affect policy and practice in maternal-child health care, such as breech birth. These research study critiques help childbirth professionals evaluate the quality of evidence and communicate that evidence to expectant parents, who may be misled or confused by information they receive from the media.
Read the complete critique on the Hannah study on breech birth, as well as critiques of studies on epidural analgesia, home birth, induction of labor and vaginal birth after cesarean (VBAC) at “When Research is Flawed” on the Research page of www.lamaze.org.
CESAREAN SECTION ARTICLES
1. The Cesarean Epidemic
This article that appeared in the LA Times on Monday Sept.
24th; 2007. Finally, the connection between increased medicalized childbirth/C-Sections in the U.S. and the rise in maternal deaths is getting the attention it deserves!
Read summary of article below and click on link for full article.
More women are dying in childbirth thanks to the high numbers of doctors and mothers who opt out of normal delivery.
By Jennifer Block
September 24 2007
Pre-term births are on the rise. Nearly one-third of women have major abdominal surgery to give birth. And compared with other industrialized countries, the United States ranks second-to-last in infant survival.
For years, these numbers have suggested something is terribly amiss in delivery wards. Now there is even more compelling evidence that the U.S.
maternity care system is failing: For the first time in decades, the number of women dying in childbirth has increased.
The complete article can be viewed at:
For further information check out the Safe Motherhood USA website at:
http://www.rememberthemothers.org. The Safe Motherhood Initiatives-USA is a partnership of organizations whose goal is to reduce maternal mortality in the United States. SMI was launched on October 25, 1997, the Tenth Anniversary of the International Safe Motherhood Initiative.
They launched a quilt project; each patch has the name and birth date and death date of woman who died of childbirth-related causes. The quilt travels and can be brought to your venue — a powerful tool to educate about this hidden crises in the US!
For further information check out the Safe Motherhood USA website at:
2) Giving Birth with Confidence Blog:
Most Women Don’t Want Cesareans
In a recent post on the Lamaze Giving Birth with Confidence Blog entitled, “What Women Want,” Judith Lothian, RN, PhD, LCCE, FACCE, writes about a new study that reports that most women disagree with the provision of cesarean surgery upon request. The study, published by the American Journal of Obstetrics and Gynecology, contradicts the current belief that many women are electing to have cesarean surgery. In the study, 95 percent of the women assessed did not believe maternal request cesareans were advisable and 93 percent believed that normal vaginal birth is safer for the mother.
Read this and more posts on current issues from Charlotte DeVries and Judith Lothian, authors of The Official Lamaze Guide: Giving Birth with Confidence, at the Lamaze Giving Birth with Confidence Blog. Share your own views with the authors and other readers by posting your comments to the blog.
CENTERING PREGNANCY ARTICLES
1) Los Angeles Best Babies Network and Eisner Pediatrics and Family Medical center Partner to Expand Centering Pregnancy in Southern California
from April 1, 2008 Los Angeles Best Babies Network Perinatal e-News.
LA Best Babies Network will partner with Eisner Pediatric & Family Medical Center, to create a Southern California CenteringPregnancy® Consortium and to provide training for five clinics on the CenteringPregnancy® model of group prenatal care. Funding for the CenteringPregnancy® Consortium and training was provided by a $49,000 grant from the March of Dimes.
CenteringPregnancy® is designed to maintain the essential components of quality prenatal care by providing assessments, education and medical and psychosocial interventions, while empowering mothers-to-be to manage their own health care and learn from each other. CenteringPregnancy® creates an atmosphere and opportunities for peer group support to reduce the sense of isolation that participants may face in the medical setting and in their personal lives. As a result, the CenteringPregnancy® model is a proven standard for improving pregnancy outcomes and reducing preterm births1.
In the CenteringPregnancy® model, women join groups of 8 to 12 expectant mothers with similar due dates (partners are also welcome) for their prenatal visits. Within this nurturing environment, women actively engage in their pregnancy by learning self-care activities such as checking their own blood pressure and weight, as well as monitoring fetal growth and heartbeat with either their physician or a certified nurse midwife. Health topics are covered in group sessions with the provider and individually as needed; topics include: nutrition, exercise, childbirth, breastfeeding and parenting among others.
“The CenteringPregnancy® model offers much more than the traditional model in which expectant women have individual visits with their provider during the prenatal period,” says Janice French, CNM, MS, director of programs for LA Best Babies Network. “CenteringPregnancy® participants report that they often learn more about their own health, and their baby’s health by questions that others ask. The group discussions also provide important emotional support for women sharing the experience of pregnancy.”
To learn more about the development of the Southern California CenteringPregnancy® Consortium or to learn how your clinic can apply for CenteringPregnancy® training, please contact Sandra Trinidad, MPH, RD, care quality program coordinator for LA Best Babies Network at (213) 250-7273, ext. 111 or STrinidad@LABestBabies.org
Novick, Gina. CenteringPregnancy® and the Current State of Prenatal Care. Journal of Midwifery & Women’s Health, 2004:49:405-411.
1) Epidurals Hamper Breastfeeding
Breastfeeding may be affected by how a woman gives birth.
Having an epidural to relieve labor pains is associated with problems breastfeeding, a study suggests. Researchers said those who have the anaesthetic are more likely to have problems in the first week after birth and to stop breastfeeding early.
University of Sydney researchers looked at 1,300 women who gave birth in 1997.
A chemical in epidurals may affect babies or it may be that women who do not have pain relief are more likely to persist with breastfeeding, they said.
However, a UK expert said that while the International Breastfeeding Journal study was interesting, women should not worry.
Around 20% of UK women have epidurals – inserted into a space near the spinal cord – to ease the pain of labor. Although the findings of this study are interesting and warrant further investigation, it is so far a theoretical concern Pat O’Brien Royal College of Obstetricians and Gynaecologists
The researchers looked at the women’s childbirth and breastfeeding history.
Of the 416 who had an epidural, 172 also had a Caesarean section.
Although 93% of the women studied breastfed their baby in the first week, those who were given an epidural were much more likely to have problems.
They were also likely to completely stop breastfeeding before six months compared with women who did not have any pain relief.
Three-quarters of those who had no analgesia were breastfeeding at 24 weeks, compared with 53% who received pethidine or epidurals.
The researchers, led by Dr Siranda Torvaldsen, say: “There is a growing body of evidence that the fentanyl component of epidurals may be associated with sleepy infants and difficult establishing breastfeeding.”
They add: “Whatever the underlying mechanism, it is important that women who are at higher risk of breastfeeding cessation are provided with adequate breastfeeding assistance and support, both in the initial postpartum period [just after birth] and the following few months.”
Pat O’Brien, a spokesman for the Royal College of Obstetricians and Gynaecologists, said it was possible that fentanyl had an effect on the baby.
But he added: “There are other factors which may explain this link, including that if a woman chooses not to have an epidural, she may also be more motivated to persevere with breastfeeding.
“Also, a lot of those women who had epidurals also went on to have Caesarean sections which – unless you have a lot of support – make it difficult to breastfeed because it’s harder for women to pick their babies up.”
He added: “For a woman who wants an epidural, there are a wide range of obvious benefits, and although the findings of this study are interesting and warrant further investigation, it is so far a theoretical concern.”
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