Monday, June 9, 2008

Some Birth Research Headlines

Courtesy of the Lamaze Institute for Normal Birth Research Summaries:

Prenatal Diagnosis of Suspected Fetal Macrosomia Increases Risks of Cesarean Section and Maternal Morbidity without Improving Newborn Outcomes

Sadeh-Mestechkin, D., Walfisch, A., Shachar, R., Shoham-Vardi, I., Vardi, H., & Hallak, M. (2008). Suspected macrosomia? Better not tell. Archives of Gynecology and Obstetrics, doi: 10.1007/s00404-008-0566-y.

"An initial suspicion that the baby is large may instill fear in the pregnant woman which may impede both her confidence in her body and her labor progress. Slow labor progress reinforces the suspicion that the baby is big and more aggressive management ensues. This management often hinders the woman's ability to move freely and assume the positions that may help her baby negotiate through her pelvis, further slowing progress and reinforcing the perceived need for surgical intervention. Based on this study and previous evidence, women should strongly consider refusing tests late in pregnancy intended to estimate fetal weight.

"The estimate itself may be bad for her health because the care provider's expectation that the baby will be macrosomic appears to increase both unnecessary medical intervention and the morbidity that may accompany it"
(exerpt from the Lamaze Research Summary).

Women Having Spontaneous Vaginal Birth Without Episiotomy Least Likely to Experience Postpartum Pain

Declercq, E., Cunningham, D. K., Johnson, C., & Sakala, C. (2008). Mothers' reports of postpartum pain associated with vaginal and cesarean deliveries: Results of a national survey. Birth, 35(1), 16-24.

"One argument made for elective cesarean surgery is that it avoids the pain of labor. Its proponents also allege that surgery occurring before labor offers advantages over intrapartum surgery. This study, however, finds that women having cesarean surgery are more likely to experience pain that interferes with routine activities and to experience long-term pain than women birthing vaginally and that timing of the surgery makes no difference.

"Women considering elective surgery to avoid labor pain should be advised that while labor pain can be controlled, cesarean surgery substantially increases their risk of experiencing many months of pain postpartum or pain that affects their quality of life. Instrumental vaginal delivery likewise increases the probability of experiencing perineal pain in both the short and long term compared with spontaneous vaginal birth"
(exerpt from the Lamaze Research Summary).

Prenatal Yoga May Result in Less Labor Pain, Shorter Labor

Chuntharapat, S., Petpichetchian, W., & Hatthakit, U. (2008). Yoga during pregnancy: Effects on maternal comfort, labor pain and birth outcomes. Complementary Therapies in Clinical Practice, 14(2), 105-115.

"This study provides evidence that regular yoga practice in the last 10-12 weeks of pregnancy improves maternal comfort in labor and may facilitate labor progress. The researchers offer several theories for these effects. First, yoga involves synchronization of breathing awareness and muscle relaxation which decrease tension and the perception of pain. Second, yoga movements, breathing, and chanting may increase circulating endorphins and serotonin, "raising the threshold of mind-body relationship to pain" (p. 112). Third, practicing yoga postures over time alters pain pathways through the parasympathetic nervous system, decreasing one's need to actively respond to unpleasant physical sensations.

"Prenatal strategies that help women prepare emotionally and physically for labor may help reduce pain and suffering and optimize wellbeing in childbirth by providing coping skills and increasing self-confidence and a sense of mastery. More research is needed to confirm the findings of this study. However, yoga's many health benefits and the lack of evidence that yoga is harmful in pregnancy or birth provide justification for encouraging interested women to incorporate yoga into their preparations for childbirth"
(exerpt from the Lamaze Research Summary).


AzĂșcar said...

OK, first of all, I did yoga during my last pregnancy. I thought it made a big difference in keeping me sane and limber, I'd definitely recommend it.

Second, I am so upset that I didn't run into that article about larger babies until now. I had a friend who was told by her OB (surprise, surprise) that her baby was getting 'too big'. This is patently ridiculous since my friend is NOT a small girl, she's at least 5'9" and her husband is well over 6 feet. It only stands to reason that they'd have a larger baby--HELLO.

However, the OB totally freaked her out and told her she was going to have a baby over 9 pounds (oh no, the horror.) So he induced her early and SURPRISE, SURPRISE, she had a c-section. I know, what a shocker. Anyway, I'm frustrated that even though I, and another friend in common tried to broach the subject that the OB could be WRONG, our friend didn't listen at all to our pleadings.

I'm not saying that a c-section is the end of the world, but I am saying that I'm pretty sure this one could have been avoided. It's all very upsetting to me. ARGH.

Lani said...

I hear ya. It's all very upsetting to me too. One of the hardest things for me to come to terms with is the fact that many women just don't care or don't want to know. And I can't make them. Dang it. I wish I could get all women to be so informed that these things wouldn't happen (unnecessary c-sections, etc.). But often the ones who could most benefit from the information just don't want it, and the ones most interested in becoming informed would have done so anyway. So I'm preaching to the choir. Sigh.

Fig said...

I was an overdue, 9-pound baby, and I came outta there just fine - to an untorn, undrugged mother.

One of the crowning achievements of my life. He he.

Buscando la Luz said...

Way to go, Fig (and mama Fig). You done made me proud.