delivery
Mode of delivery and asthma -- is
there a connection?
The results of this study in Finland suggests
that caesarean section delivery may be associated with an
increased prevalence of atopic asthma.
Kero J, Gissler M, Gronlund MM, Kero P, KoskinenP, Hemminki
E, Isolauri E Mode
of delivery and asthma -- is there a connection? Pediatr
Res 2002 (Jul); 52 (1): 6-11
Forceps Up the Risk of Fecal Incontinence
Forceps-assisted childbirth significantly boosts
a woman's risk of fecal incontinence, researchers report.
Investigators pooled data on more than 7,800 mothers. Ten
percent reported experiencing fecal incontinence during the
year following childbirth. Those whose deliveries involved
forceps and who experienced tears in the anal sphincter were
at double the risk of fecal incontinence during the three
months following delivery, compared with mothers whose deliveries did not involve
forceps.
MacArthur C, Glazener CM, Wilson PD, Herbison GP, Gee H, Lang GD, Lancashire
R Obstetric
practice and faecal incontinence three months after delivery BJOG
2001 (Jul); 108 (7): 678-683
Episiotomy Increases Risk of Incontinence
According to new
study conducted at Harvard Medical School, women who undergo episiotomy during
childbirth are more likely to develop anal incontinence, compared with
women who have "natural" childbirth - even if they withstand
perineal tearing. The study enrolled 209 women who received
a midline episiotomy, 206 women who endured spontaneous perineal
tearing and 211 women who experienced neither event. All
subjects had singleton deliveries.
At 6-month follow-up, investigators determined that episiotomies tripled the
risk of fecal incontinence and doubled the risk of flatus incontinence. This
finding was independent of maternal age, complicated labor, or instrument use
during delivery (i.e., forceps).
The study's authors concluded that, "midline episiotomy is not effective
in protecting the perineum and sphincters during childbirth and may impair
anal continence."
Signorello LB, Harlow BL, Chekos AK, Repke JT Midline
episiotomy and anal incontinence: retrospective cohort study Brit
Med J 2000 (Jan 8); 320 (7227): 86-90
Breech Baby? You May Not Need A C-Section After
All
Just because your baby decides he'd rather
be born bottom-first doesn't necessarily mean you should
get a cesarean section, says a study in the British Journal
of Obstetrics and Gynecology. In fact, routine c-sections
for women whose full-term babies are breech may raise the
women's risk of complications such as urinary tract infections,
endometriosis, hysterectomy, pulmonary embolism, and cardiorespiratory
arrest. Researchers at University Hospital in Geneva examined
705 consecutive breech deliveries and found that women who
delivered vaginally were not only healthier but also were
out of the hospital sooner than those who'd scheduled c-sections.
The study found there were significantly fewer maternal complications
in the planned vaginal delivery group than in the elective
caesarean section group. The researchers found that neither
delivery method affects the babies' risk of complications,
and went on to conclude "There is no firm evidence to recommend
systematic elective caesarean section for breech presentation
at term."
Irion O; Hirsbrunner Almagbaly P; Morabia A Planned
vaginal delivery versus elective caesarean section: a study of 705 singleton
term breech presentations Br J Obstet Gynaecol. 1998 (Jul); 105
(7): 710-717
Forceps, C-Section Linked With Head Injury
Babies delivered with the help of surgical
intervention are at a greater risk of head injury than are
babies born by natural childbirth, according to a paper in
the New England Journal of Medicine.
As part of the study, researchers reviewed data on 583,340 babies born between
1992 and 1994. One-third of these babies were born with the help of surgical
procedures such as vacuum extraction, cesarean section (performed during labor)
or forceps. Babies born via operative techniques were up to 3.5 times more
likely to suffer intracranial hemorrhage, compared with children who were delivered
spontaneously. However, no additional risk was seen among children born via
cesarean section performed with no labor, indicating that abnormal labor, rather
than delivery method, may be the causative factor in many head injuries.
Towner D, Castro MA, Eby-Wilkens E, Gilbert WM Effect
of mode of delivery in nulliparous women on neonatal intracranial injury N
Engl J Med 1999 (Dec 2); 341 (23): 1709-1714
Low Birth Weight ups Asthma Risk
Low birth weight boosts an individual's risk
of asthma, say researchers in the journal Thorax.
A total of 8,960 people were enrolled in the British Cohort study in 1970.
Periodically, the participants completed questionnaires recording height, weight
and symptoms of asthma experienced during the previous 12 months. The study
found that low birth weight increased a subject's odds of having asthma at
age 26.
Shaheen SO, Sterne JAC, Montgomery SM, Azima H Birth
weight, body mass index and asthma in young adults Thorax
1999 (May); 54 (5): 396-402
C-Section Tied to Risk of Allergies
Researchers recently unearthed another reason
for parents to choose natural childbirth over elective Caesarean
section (C-section): allergy prevention. It seems that C-section
delivery may predispose an infant to atopic disease, according
to a paper presented at the annual meeting of the American
Academy of Allergy, Asthma and Immunology in Orlando, Florida.
Investigators in Finland analyzed umbilical cord blood from 16 infants delivered
via elective C-section and 12 infants delivered vaginally. The study found
that cord blood from babies delivered via C-section contained one-third the
number of IgA antibodies, compared with controls. In addition, cord blood from
infants delivered via C-section had less interleukin 6 and 12. Experts speculate
that stress from C-section delivery initiates biochemical changes that make
infants more susceptible to allergy. However, the study's authors stress that
more research is necessary before a clear link may be established. Specifically,
they note that studies involving older children are needed.
Sütas Y The role of mode of delivery in atopy: elective
caesarean section delivery impairs the capacity to generate IgA and IL
12 American Academy of Allergy, Asthma and Immunology, 55th
Annual Meeting March 15,1999
Birthing Naturally at Home
"If left alone in labor, the
body of a woman produces most easily the baby that is not interfered with...
If left alone, just courage and patience are required."
- Grantly Dick-Read, Childbirth without Fear: The Principles and Practice of
Natural Childbirth
There are Two
Philosophies on Birth , however most women are not
exposed to both.
Obstacles in choosing a natural birth
It seems that as much as we see the awareness of natural
birthing expanding we also see a continued increase in the
c-section rate. It's time to look at what is impeding the
movement of natural birth in our modern societies.
"Obstetricians
should be heroes" by Jock Doubleday
The
Assault on Normal Birth by Henci Goer, published in
the current issue of Midwifery Today offers further referenced
insight.
Is home birthing really safe?
Outcomes
of planned home births in Washington State : is one
study where the myth is perpetuated. Please refer a review
of this study and how the myth gets perpetuated by
junk science.
Search
the literature to help dismantle the myth that home
births are not safe.
Reassurance for the natural process
Women
who listen to their inner promptings . Stories of women
who went with the process. Download the article and help
reconnect your patients to their innate possibilities.
Offer
mothers the information to make informed choices about
birth. Three excellent resourses for natural birthing at
home.
There's
no place like home *** The
Home Birth Choice *** Home
Birth Website ***
Patient education for options is
timely
Finally, a recent rise in obstetric malpractice insurances
are closing down obstetric wards around the country.
"...In
all, more than 1,300 health care institutions have already
been affected, according to a survey by the American Hospital
Association. The survey, released in June, found that 20 percent
of the association's 5,000 member hospitals and other health
care organizations had cut back on services and 6 percent had
eliminated some units. Many of those units are obstetric wards,
where medical mistakes have historically led to expensive jury
awards and settlements."
"Rise in Insurance Forces Hospitals to Shutter
Wards." NY Times online.
Epidurals May Affect Newborns
A recent study published in April's issue of The Journal of the American Academy
of Pediatrics states that epidurals can cause fevers in mothers during childbirth
which in turn causes doctors to test newborns for blood and tissue infections
and treat the newborns with antibiotics. Newborns who are born to mothers with
epidurals are 4 times more likely to receive antibiotics because doctors are
concerned about the possibility of newborn infection. This is in spite of the
fact that babies of women who receive epidurals were not more likely to have
infections than those born of mothers without epidurals.