Sunday, May 20, 2007

Hmmm... Interesting...

"After working as a practicing physician for several years, I became a perinatologist and perinatal scientist, as well as a full-time faculty member at the Schools of Medicine and Public Health at UCLA. Then I became a director of maternal and child health for the California State Health Department. In that capacity, I learned that in the rural town of Madera, California, doctors had decided that they no longer wanted to attend births at the Madera County hospital. They complained that it took too much of their time and didn't pay enough. So in 1968, two out-of-state midwives were recruited by the county to fill the gap. After two years of midwifery practice at the hospital, the rate of babies dying around the time of birth in the Madera County hospital was cut in half. Alarmed that their style of maternity care was being made to look bad, the doctors in the town agreed that they would once again attend births in the hospital if the two midwives were fired. The hospital fired the midwives, the doctors returned, and soon the rate of babies dying around birth rose to its earlier levels" (Marsden Wagner, Born in the USA, p.99, emphasis added).

Thursday, May 3, 2007

Sad, but true

"We do not see childbirth in many obstetric units now. What we see resembles childbirth as much as artificial insemination resembles sexual intercourse." ~Ronald Laing, psychiatrist

Wednesday, May 2, 2007

Think you're better off with an epidural? Think again...

• Epidurals cause women’s bodies to stop or slow the release of oxytocin—slowing labor and removing the feel-good effects of the hormone. The first stage of labor tends to be about 26 minutes longer and the pushing stage 15 minutes longer in women with epidurals. Epidurals also eliminate the natural peak of oxytocin intended to occur at the time of birth to facilitate the delivery and bonding processes.

• Women with epidurals are nearly three times more likely to have Pitocin—to speed up labor—than those without epidurals.

• When the pelvic floor muscles have been numbed by an epidural, a woman’s body cannot guide the baby’s head to the ideal birth position as effectively. Babies are four times more likely to be posterior (facing up—a more difficult position for birth) in the final moments of labor when their mothers have epidurals. As a result of these complications, some women with epidurals experience difficulty pushing their babies out—doubling their risk of forceps or vacuum extractor deliveries.

• Other epidural side effects for mothers include: drop in blood pressure, difficulty passing urine, itchiness, shivering, sedation, nausea and vomiting, fever, breathing difficulty, inadequate pain relief, slurred speech, drowsiness, convulsions, postpartum weakness and/or numbness, postpartum back pain, mild to severe postpartum headache (sometimes lasting six weeks), temporary or permanent paralysis, cardiac arrest, respiratory arrest, and death. A woman’s risk of dying from childbirth complications triples when she has an epidural. (For a recent news story on the rise in epidural-related maternal deaths, see here.)

• When mother develops an epidural-induced fever, her infant tends to have poorer condition at birth, has an increased risk of having signs of brain damage, and will likely undergo an invasive sepsis evaluation to check for infection.

• Epidurals can lead to worrisome fetal heart rate changes also. This is in part because women with epidurals tend to lie down in one position for extended periods of time which can restrict blood flow to the fetus. Change of position will often improve the fetal heart rate abnormalities. When an epidural is coupled with Pitocin, the signs of fetal distress can be more prolonged and severe.

• Some data also indicate that babies born to women who had epidurals show increased risk of poor brain function at one month of age.

• As many as 85% of women in some U.S. hospitals receive epidurals.