Archive for obstetricians
A Labor and Delivery Nurse’s Views on VBAC
Nothing gets my ears perked up and my excitement stirred than chatting about birth. To be even more specific about what really gets my juices flowing are discussions surrounding VBAC births; vaginal birth after cesarean. It might make more sense to know that I am a labor and delivery nurse by trade and a mommy at heart. I get the pleasure of escorting new little souls into this life each and every shift and participate in someone’s best day and, unfortunately, sometimes their worst. I work at a Portland-area hospital and we see everything from the most natural, “normal,” labor and delivery patient to the most tragic, life-threatening situations; needless to say, it is a very special, very dynamic job and I am blessed to be a part of it. [...]
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VBAC Less Risky Than Multiple C-Sections
The National Institute for Health issued a report this week titled, Vaginal Birth After Cesarean: New Insights. The report presents evidence to support the choice of a trial of labor (TOL) as a safe option for women who have had previous c-sections.
The conclusion of the report states, “Each year 1.5 million childbearing women have cesarean deliveries, and this population continues to increase. This report adds stronger evidence that VBAC is a reasonable and safe choice for the majority of women with prior cesarean. Moreover, there is emerging evidence of serious harms relating to multiple cesareans. Relatively unexamined contextual factors such as medical liability, economics, hospital structure, and staffing may need to be addressed to prioritize VBAC services. There is still no evidence to inform patients, clinicians, or policymakers about the outcomes of intended route of delivery because the evidence is based largely on the actual route of delivery. This inception cohort is the equivalent of intention to treat for randomized controlled trials and this gap in information is critical. A list of future research considerations as prioritized by national experts is also highlighted in this report.” [...]
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Go Ahead. Eat During Labor.
A new article published today on Reuters’s website begins, “There is no reason why pregnant women at low risk for complications during delivery should be denied fluids and food during labor, a new Cochrane research review concludes.” The entry, titled No Need For Pregnant Women to Fast During Labor cites the new research findings that show that there aren’t any adverse outcomes by allowing women the option of liquids and/or a regular diet in labor. [...]
Do Epidurals Affect Babies?
In making your decision to use or not to use an epidural for pain relief during labor, have you wondered what effect the medication can have on your baby? Turns out that is a difficult question to answer. A recent article on Suite101.com titled Do Epidurals Affect Babies? says, “While it is clear that epidurals cross the placenta and reach the baby and can both indirectly and directly affect babies, we still don’t know exactly how epidurals can affect the baby in every situation and for every mother and baby.” Probably not what you wanted to hear! [...]
Oprah.com Reports on Alternative Birth Options
I am always beyond excited to see a non-sensationalist article about natural birth appearing on any mainstream website, television program or other media outlet. Though natural birth at home has been the norm throughout history, in recent times it has become a radical, outsider and even legally-banned practice in the U.S. That’s why I’m giving Oprah.com a gold star for raising awareness about the subject and letting American families know that they have other options besides hospital birth attended by obstetricians!
A recent article appearing on Oprah.com, by Fritz Lenneman, begins “With Caesarean section surgeries occurring in nearly one in three pregnancies and traditional hospital births by obstetricians costing an average of $8,000 to $10,000, some pregnant women are exploring other options. And the future of childbirth in America might start looking more like the past.” He then describes the roles of midwives and doulas in the birth process and talks about the legal challenges faced by some home-birth midwives. “Though about half of states allow at-home birth, it remains uncommon in the United States—just 1 percent of births occur in nonhospital settings including home births and birthing centers.” He also discusses alternative methods for inducing labor such as acupuncture, acupressure, walking, eating spicy foods and sex. Yes SEX! [...]
Do Men Hinder Birth?
One of my Facebook friends sent me a link to an article titled, “Having an all-female environment is the best birth plan.” In it, the revered (in some circles, mostly female) obstetrician Michel Odent has declared that “women are better off giving birth in an all-female environment because the presence of a male partner—or even a male doctor—may make her feel pressurised and/or distracted.” Yeah, I can see how that would be true. [...]
The Controversy Over Home Birth
I have recently twitted about two news articles concerning the safety of home birth. For those of you who don’t follow me on twitter, I’ll catch you up on the news. Here’s the scoop: The Huffington Post article, “ACOG Up to Dirty Tricks,” reported on the organizations efforts to collect stories solely about unsuccessful out-of-hospital births from its members to use as “data” in it’s lobbying efforts against independent midwives. And on the brighter side, USA Today published the article “Study: Home Birth With Midwife as Safe as Hospital Birth” which finds that planned home births may in fact have a lower mortality rate and fewer complications that physician-attended hospital births. [...]
Changing Prenatal Care Providers
How do pregnant women and their partners go about choosing a prenatal care provider? Often, they have not given it one bit of thought until they see two pink lines on a pregnancy test. Then it’s a mad dash to find someone you can trust to care for you during your pregnancy and give you guidance about how to birth your baby. You are not alone if somewhere down the line you realize that maybe you hadn’t initially given enough thought to who that person should be (I’ve been there!). Perhaps half way through your pregnancy you have become more educated about birth than you were when the baby was conceived. You may have changed your own views about what type of birth is right for you and now require the guidance and care of a provider who will support your vision. [...]
Why Are There So Many C-Sections?
You probably know a few women who have had c-section births and may wonder “Will I have to have one too?” The answer may lie in the type of prenatal care provider you choose and how much personal responsibility you take for the birth of your child. Recent studies put the c-section rate in the U.S. at over 30% and show it trending upward still. Because health care typically pays doctors and hospitals more for a quick c-section than it does for long, drawn-out vaginal births, there is more incentive to perform surgery and get patients in and out quickly. It’s safe to say that the health care system is providing incentives for c-sections and if you put your birth in the hands of a doctor or hospital who is paid by the insurance providers you likely have a 30% chance of having a c-section yourself—unless, of course, you have carefully selected a provider with a low c-section rate, educated yourself about the birth process and are willing to advocate for what’s in the best interest of your health and that of your unborn baby. [...]
Choosing a Doctor or OB
Since Bloom was launched a few weeks ago, I have had a couple of inquiries from women wanting recommendations for local doctors and obstetricians (OBs) who have good reputations for attending natural births. While I believe midwives are the best care providers for low-risk, normal pregnancies I understand that there are women who require the prenatal medical care of a physician but are still interested in a natural labor and delivery. I have heard it said that most OBs may only give lip service to “natural birth” or consider any vaginal birth—even those with induction, medication and other interventions—a natural birth.
However, there are a few doctors and OBs who gain reputations for being supportive of natural childbirth. I have spoken to a few of our local doulas with a lot of hospital birth experience and done some online research to be able to provide these recommendations to Bloom readers. [...]
