Showing posts with label caesarean. Show all posts
Showing posts with label caesarean. Show all posts

Hooray for homebirth

Well, hell has frozen over.

Just when I thought that the fight for homebirth in Victoria was stuck at the corner of 56th and Never Gonna Happen, Health Minister Daniel Andrews just announced that the State Government had allocated $400,000 for midwife-led home births through Casey Hospital in Berwick and Sunshine Hospital in Melbourne's west. A regional health service will also participate, but the Government has yet to decide which one.

For women who have relatively uncomplicated pregnancies, this is fantastic news and as long as the trial works over the next year, the project will be expanded throughout the public health system. While undeniably this is no good for women who may want to have a homebirth following previous caesareans (VBACs) or who are considered to be 'high risk' (e.g. obesity, 'older' mums), the fact that the State Government has actually listened to the enormous amount of feedback provided by homebirthing mums and midwives is astounding and shows real promise for a health system that can provide high quality care for women who don't want to birth in hospital.

Yay!

Caesarean = rape?


Image credit: www.caesarean-art.com

As we all know, the caesarean rate (emergency and elective) has risen dramatically over the past decade in most of the industrialised world and 'natural' childbirth has become something of a vestigial organ.

For many women, a caesarean is not only painful but also traumatic. Somehow birth has become only about a healthy outcome and not necessarily about the process or the woman actually giving birth. There is now a growing subculture of women who compare their caesarean births to rape given the lack of control they felt they had over their bodies, the antagonism of hospital staff towards their birth choices and of course, feelings of violation. Recent articles about birth rape are linked to the story of an Arizona mother, Jessica Szabo, who wants to have a VBAC (vaginal birth after caesarean) but is being refused by her local hospital. The hospital argues that all VBACs must have an 'elective caesarean'. In fact, she's so mad that she has written the following message on her minivan:

"Page Hospital enter my body without my permission ... sounds like rape to me!"

There is even an anonymous website devoted to caesarean-inspired art evoking the trauma and pain some women associate with the procedure. Truly haunting (see above).

What do you think?

News you can use

Monday news roundup:

The Society of Obstetricians and Gynaecologists of Canada says a C-section should not be offered to a pregnant woman unless there is a valid medical reason to perform one. But, a University of British Columbia study found that 2 per cent of obstetricians were in favour of a woman's right to choose a C-section for herself, even in the absence of a medical indication.

Speaking of caesars, Charlotte Church says giving birth naturally was pretty rough: "It's absolutely, disgustingly horrendous.It's shocking I tell you that. I had both babies at home, two home births, just with gas and air. It was horrendous. I mean it was amazing and awesome and crazily whatever, a completely different experience but you know, I might do it again because I'm a little bit of a sadist that way."

Over in supermodel preggo land, the maternity style wars were on as Heidi Klum and Gisele Bundchen tooled around town with their bumps in all their glory

In case you missed it, Shiloh Pitt, 3, lost her front tooth. This has prompted such heated internet discussion, forcing Brangelina to issue a press release answering questions about the obvious gap in Shiloh's smile. Most people think Shiloh is too young to start losing teeth, so most of the web is settled on the idea that Zahara either clocked her in the face or she has been eating skittles for breakfast.

Speaking of half-pint celebs, Suri Cruise is not only a style maven for other three year olds, her mother, Katie Holmes points to Suri as her inspiration for her new fashion line she is launching with her stylist Jeanne Yang: "
It has been my dream forever to be in fashion and I'm truly inspired by my daughter Suri. She just loves dressing up so I decided to launch this exciting venture with Jeanne." Um, let's just hope that her new line doesn't include sparkly shell shaped handbags or kitten heels.

Oh, and Nicole Richie has snapped back into her size zeros in just under 2 weeks. Ho Hum.

Britain's oldest mum back to work

Welcome back to moral panic Monday.

Elizabeth Adeney, Britain's 'oldest mum' has given birth to her first son at the age of 66 back in May to a phalanx of media scrutiny. Criticised for being too old, a divorcee and for accessing IVF in the Ukraine, Adeney refused to talk to the media noting that she felt young at heart.

Now, poor Adeney is being slammed for returning to work 4 weeks after giving birth. Adeney was spotted being driven to work by a friend, leaving her newborn son Jolyon, with a live-in nanny. As Adeney gave birth by caesarean the Daily Mail further criticises her, speculating that her caesarean scars probably have not been given a chance to heal properly:

"Sue Jacob, adviser to the Royal College of Midwives, said: 'Hormonally women are still very delicate after four weeks and caesarean scars will not have healed properly. Babies still need the consistency of a mother's attention at this point and new mums especially will be exhausted.
'There's no reason why women should not carry on with their careers as soon as they are able. But it's only a select few women who are able to get the support necessary to do this. It isn't what we expect normal, ordinary women to be able to do."

As I said in an earlier post, the issue of having IVF at 66 and being an 'older' mum are actually separate issues. Elizabeth Adeney owns her own company, has a fabulous home and the ability to hire the support that she needs in order to help her be a good mother. I don't see why Adeney having a child at 66 is any different from older men like Larry King having young children well into their 70s. What really bothers me is that Adeney's reported 'desperate' desires for children throughout her life is being used against her. It's like, 'How on Earth could this women conceivably return to work *shock horror* when she wanted a child so badly'? GIve me a flipping break. Celebs return to work 2 minutes after they have babies and most of them use nannies and whomever else they can to help them get through the day as career women, wives/partners and mothers. If Adeney wants to go back to work, why is it anyone's business but her own?

Pryor Parenthood

Hey, just found Rain Pryor's (Richard Pryor's daughter/comedienne/actress) blog about motherhood. She talks about her experiences with miscarriage, pregnancy and breastfeeding. Rain even watched her own caesar:

"I decided to look up, I could see the entire surgery in the light. I kid you not. There were my insides being taking out and moved this way and that. Lots of blood. I was in total disconnect. I knew it was me but, due to the numbing sensation I really couldn't connect. I was just laying there watching every thing as if I was in a hospital viewing booth."

Read more: Pryor Parenthood

The new 'natural' caesarean

Maybe I'm missing something but does the idea of a 'natural' caesarean sound a little ridiculous to anyone else?

Thanks to an enterprising OB, Professor Nicholas Fisk, some women in the UK are experiencing slower, more pleasant caesarean births with the lights dimmed low, the opportunity to see their baby emerging from the womb and immediate skin-to-skin contact. The idea is to make a caesar more like vaginal birth.

"It struck me that all the effort was going into changing normal childbirth but that Caesarean section was still steeped in old surgical rituals,” says Fisk. “In some cases I was horrified; the baby would be dragged out like a tumour and passed to several medical staff before the mother. It was ripe for reform.”

Don't get me wrong. I think this is a fabulous and timely intervention, but perhaps the word 'natural' is somewhat ill-placed in describing this updated version of a caesar. I'm all for women feeling comfortable and having every opportunity to bond with their babies during surgical birth but let's not kid ourselves here. Surgical birth is surgical. Vaginal birth is vaginal. While both types of birth can be joyous experiences, dim lights and a dropped surgical drape do not change the fact that too many women in the western world are having caesars. Making caesars a little more pretty and a little less scary is good in the short-term but I bristle at the idea that a happier, healthier caesar will only encourage more women to think that a caesar is preferable.

Read more: The new 'natural' caesarean

Caesareans rising to alarming rates in US

Bad news: The caesarean rate has risen for the 11th year in a row in the US. With the caesar rate hovering at nearly 32% of births, Pam Udy, president of the International Caesarean Awareness Network advocacy group, has said, "Every pregnant woman in the US should be alarmed by this rate".

Bad news: The teen birth rate has risen for the second straight year thanks to crucial cuts in sex education funding in American schools. Basically, this is a case of too much sex and not enough contraception.

The most recent statistics have revealed that the US birth rate skyrocketed in 2007 to 4.3 million babies and nearly 40% of those births were out-of-wedlock and to mostly Hispanic and African-American women.

Good news: Premature and low-birth weight babies are decreasing after a long upward trend.

Source: Caesareans soar in the new US baby boom

Epidurals on the way out in the UK

In Australia, it is no secret that medicalised birth is increasingly becoming the norm. With a greater push for less intervention and more one-to-one care, maternity reform is a red hot issue on the national agenda. Nevertheless, while the prospect of having wholly funded home births and more accessible birth centres throughout the country is exciting, should less intervention mean no intervention?

In the UK, doctors and patients are struggling over new regulations surrounding the use of epidurals during birth. As new guidelines have characterised the use of epidurals and caesareans as 'unnatural' in a bid to reduce interventions by up to 40%. The goal of the new guidelines is to ensure that more women are having 'normal' or 'traditional' birth. Obstetricians, however, have problems with this.

Kim Hinshaw, a consultant obstetrician at Sunderland Royal Hospital, said: ‘I have major concerns with this. I don’t think we will ever reach a figure of 60% normal delivery using this definition. For example, in Sunderland we have an epidural rate in first labours of 60%.

‘This definition implies that if you ask for an epidural for pain relief, but go on and deliver normally after a six-hour labour, your birth was not ‘normal’. That is a disgrace.’

And Professor James Walker, a consultant obstetrician at Leeds Teaching Hospitals NHS Trust added: ‘This is a very rigid definition of what normal birth should be. Epidurals should not be done without reason; they should be kept to a minimum. There are some women, however, who require an epidural because they cannot cope with the pain in any other way.’

I have to agree. While I am fully in favour of supporting national guidelines that seek to minimise the unnecessary interventions, at the same time, I bristle at the thought of women giving birth in pain and not being allowed to have relief if they ask for it.

Would you be happy with this model of care in your own country?

Source: http://tinyurl.com/ccz8vh

Dati back at work and causing more firestorms

French Justice Minister, Rachida Dati has returned to work 5 days after having a caesarean section and giving birth to her first daughter...

And the 'French feminists' (sure, blame the femmos) are enraged and Dati for setting a poor example. French women are entitled to 16 weeks paid maternity leave.

"This is scandalous," said Maya Sturduts from the National Collective for the Rights of Women.

"Employers can now use this to put pressure on women", she said, especially during the current tough economic times when employers may be looking for excuses to cut staff.

Others are claiming that Dati 'had' to return to work, lest she lose her place in male-dominated political circles.

Not sure how I feel. Pregnancy is not an illness. Women shouldn't be judged for returning to work quickly. On the other hand, it would be so sad to think that this women, upon the joyous birth of her first child, felt she would lose her credibility as a politician if she took the maternity leave she is legally entitled to take.

Source: http://tinyurl.com/8mnhax

Maternity leave = fewer caesars and better breastfeeding

In case the Australian and US governments need another to institute paid maternity leave: two new studies have shown the health benefits of maternity leave for both mother and baby.

One of the reports found that women who started their maternity leave in the last month of their pregnancy were less likely to have caesarean deliveries, while the second found that new mothers were more likely to establish breast-feeding the longer they stayed out of work.

A report published in Women's Health Issues found women who took leave before they gave birth were almost four times less likely to have a primary caesarean section as women who worked through to delivery.

The second report published in Pediatrics found that women who took less than six weeks of maternity leave had a four-fold greater risk of failure to establish breastfeeding, while women who took six to 12 weeks of maternity leave had a two-fold greater risk of failing to establish breastfeeding.,

Source: http://tinyurl.com/89c5qk

Choices in childbirth more complex in 2009

Welcome to 2009. What better way to celebrate the new year then to see new statistics from NSW that show a huge disparity between childbirth intervention rates in private and public hospitals. According to recent reports, here are some humbling statistics:

  • the caesarean rate is hovering close to 40% in private NSW hospitals
  • between 1/4 and 1/3 of women in private hospitals have an episiotomy compared to only 10 % in public hospitals
  • forceps and vacuum deliveries comprise nearly 15% of all private hospital births
  • in one NSW private hospital, only 4% of women go without any pain relief
Whereas American private hospitals have long been the 'bad guy' when it comes to intervention in childbirth (nearly 50% of women in some New York hospitals are induced), it looks like Australia's private health system is increasingly putting some women in danger of being subject to a similar cascade of intervention as the age of childbirth increases, more women are requesting elective caesareans and more middle-aged women have private health insurance and are increasingly concerned about any 'risk' to the health of their foetuses.

Although there are not any easy solutions to such a complex issue, particular when it comes to the role of choice and power in hospitals, it seems that some things can be addressed quite easily. For instance, midwives often encourage women to give birth standing up or in other positions that progress labour more quickly and effectively. When women have epidurals, standing is not possible.

Any Aussies out there who feel they were forced to 'choose' intervention during birth?

Source: http://www.smh.com.au/news/national/the-painful-truth-about-childbirth/2009/01/02/1230681748836.html

Avoid caesars with vitamin D

According to a new study from the Boston University School of Medicine, women who have a deficiency of vitamin D are four times as likely to have a caesarean birth. The authors of the study think that vitamin D deficiency has an effect on muscle strength which may contribute to difficulties giving birth.

"At the turn of the 20th century, women commonly died in childbirth due to 'rachitic pelvis,' " write Anne Merewood, MPH, IBCLC, from Boston University School of Medicine in Massachusetts, and colleagues. "Although rickets virtually disappeared with the discovery of the hormone 'vitamin' D, recent reports suggest vitamin D deficiency is widespread in industrialized nations. Poor muscular performance is an established symptom of vitamin D deficiency, [and] the current US caesarean birth rate is at an all-time high of 30.2%."

Sources:
http://www.medscape.com/viewarticle/585864
http://www.washingtonpost.com/wp-dyn/content/article/2008/12/22/AR2008122201106.html

Fat mothers, no more?

Looks like the days of 'eating for two' are well and truly over. Obesity during pregnancy is public enemy #1 in the eyes of biomedicine.

In Chicago (where I currently am blogging), Northwestern University's School of Medicine is opening a centre focusing exclusively on 'treating' and researching obesity, especially in pregnancy.

According to recent statistics, in 2007, almost half of the women who gave birth at Northwestern Memorial's Prentice Women's Hospital (where I was born!) were categorized as overweight, meaning they had a body-mass index between 25 and 29.9 before pregnancy. An additional 12 percent had a BMI of 30 or greater, the definition of obesity.

In Melbourne, it is suggested that more than 30 obese women are presenting at hospitals every month which is a huge increase over the last five years. At least 35% of pregnant patients are now considered to be obese. Doctors are saying that overweight pregnant women are "posing serious challenges" as it becomes increasingly difficult to monitor foetuses on ultrasound machines and monitor their heart rates. On a more practical level, medical staff complain that the hospital does not even have appropriate trolleys to transport pregnant women who weigh more than 150kg. As a result of the reportedly 'huge' rise in overweight mothers, Australian obstetricians are suggesting that obese women should have their weight vigiliantly monitored throughout pregnancy.

Unsurprisingly, overweight women are now being encouraged to seek out gastric band surgery prior to falling pregnant as a means of avoiding the 'risks' associated with obesity during pregnancy.

So rather than providing services for overweight women to learn about sensible weight loss, they are being encouraged to look to a surgical solution. This comes from the same band of obstetricians who continually lament the high rates of caesarean sections throughout the developed world (many of which are attributed to obesity in pregnancy). Surely, there has to be a better way to lower high rates of surgical birth associated with obesity other than asking obese women to have surgery to lose weight.


Sources:http://www.chicagotribune.com/features/health/chi-obesity-centernov28,0,3499140.story
http://www.theage.com.au/national/huge-rise-in-obese-mumstobe-20081115-67p0.html
http://www.reuters.com/article/healthNews/idUSTRE4AH8TR20081118

'Natural' birth is best?

Mothers who give birth naturally are more responsive to the cry of their baby than those who choose to have a Caesarean, American research suggests.

A research team at Yale carried out brain scans on 12 women two to four weeks after they had given birth - known as the early postpartum period.

Half had a Caesarean, the other half gave birth naturally.

The differences in brain activity were found in regions that not only appeared to influence a mother's response to her child, but also to regulate her mood.

It seems oxytocin, the 'love' hormone is a critical factor in the bonding process.

The researchers suggest that women who have caesareans should be encouraged to cuddle their babies straight after birth.

I think this is all a bit problematic. Sure we have known for quite a long time that oxytocin does a number of important things for birth and bonding. Yet, making sweeping claims on the basis of a sample of 12? Hmmm.

Anyone have a different experience? Did you have a caesarean? How was your bonding experience? Did you get to cuddle your baby straight away? If not, how long did you have to wait?

Source: http://news.bbc.co.uk/2/hi/health/7594282.stm

Epidurals don't always work!

And I thought having a caesarean was bad with pain medication...

A woman in the UK is planning to sue her hospital for failing to give her proper pain medication during an emergency caesarean. After an epidural, Sarah Carberry, 27 says she could still wiggle her toes and feel her legs but her doctors said that was 'normal'. When they started to cut into her womb, she was quite understandably in agony.

Note to self: wiggling body parts before major surgery = not good

Source: http://www.telegraph.co.uk/news/uknews/2660774/Mother-sues-hospital-over-caesarian-birth-without-pain-relief.html

Big stars, bad baby names

Oh no she didn't!

Celebrities can get away with a lot these days. Wearing outfits that don't match. Washing their hair with Evian. Having personal umbrella holders.

Gwen Stefani had another baby boy by caesarean on Thursday. And she named him......

Zuma. That's right Zuma Nesta Rock Rossdale.

Seriously. SERIOUSLY?!

Source: http://www.people.com/people/article/0,,20210744,00.html

Caesarean boom in New York

Scary.

New York City's cesarean section rate has increased by 24% over the past six years to an average of nearly 31%, and rates are on the rise at nearly every single city hospital, according to new data released by Choices in Childbirth.

Contrary to popular belief, caesar rates are not going up because of more 'elective' caesars or because more 'older' women are getting pregnant and are at greater 'risk' of complication. For instance, only 1 in 1600 caesars are 'elective. According to this new data, caesars are increasing from women across every age, race, and socio-economic status.

The most likely explanation seems to be that American birth is just getting more medicalised: women are less informed about alternative birth options and interventions are increasing due to fears of medical malpractice.

As a result Choices in Childbirth, a non-profit maternity education group in New York is urging NYC to create an online database providing info on all New York hospitals so women know their options when they are choosing a place and a method for birth.

Source: www.choicesinchildbirth.org
http://www.medicalnewstoday.com/articles/118284.php

Oh no you didnt!


Hell has frozen over.

*deep breath*

I just found an article about post-baby weight loss in the New York Daily News (I guess that says it all) in which the author quotes some $%&*head surgeon that says caesareans are great for this reason:

"You burn a lot of calories healing after a C-section. It's a serious surgical procedure - you're cutting through the abdominal wall and the uterus," he explains. "Your body is trying to repair itself and that stimulates your metabolism. Plus you're usually on a liquid diet for the first few days afterward. You can lose about 10 pounds. So if you keep that off, watch your diet and get back to exercising, you can look really good."

Right. let's just go back to the 'cutting through the abdominal wall' bit. How about 'Ouch'? Um, I think weight loss is perhaps the last thing on your mind when you are trying to prevent your intestines from bursting out of your surgical scar.

There you have it, ladies. Elect to have a caesar and forget about going to the gym. Your immune system will take care of the weight loss for you.

New Mothers Speak Out

It seems that women have more to worry about than just postnatal depression. About 15% of new mums experiences PND. A new study suggests that some American women (about 9%) are also experiencing post-traumatic stress disorder due to childbirth. It i thought that the increase in the number of medical obstetric procedures in labor and delivery, like Caesarean sections and premature births, could be contributing to PTSD. These women often report feeling powerless in during their births. African-American women, those without private health insurance and women with unplanned pregnancies were more likely to have PTSD symptoms. The survey, called New Mothers Speak Out, also covered a range of other post-birth issues.

Here is a good podcast about PND: http://podcast.mktw.net/wsj/audio/20080804/pod-wsjzimmerman/pod-wsjzimmerman.mp3

Sources: http://www.childbirthconnection.org/ http://online.wsj.com/article/SB121789883018612223.html?mod=googlenews_wsj


Olympic frenzy = caesarean boom

For pregnant Chinese women, 8 August is particularly auspicious day for giving birth and not only because this is the slated start for the Beijing Olympics.

According to Chinese tradition, the eighth day of the eight month of the eighth year is considered extremely lucky. Coupled with the opening of the Games, giving birth on this day is thought to bring good luck to a baby.

You can guess what happens next. According to local reports, expectant women in Chinese cities have been requesting caesareans for that day. One hospital in Shijiazhuang has received requests from 78 pregnant women.

It has been noted that China has also been experiencing a baby boom this month because many women tried to time their pregnancy around giving birth in August.

Source: http://www.dnaindia.com/report.asp?newsid=1181375