Monday, July 21, 2014

Climate Change in Birth

There is much discussion regarding climate change in the world.  There should also be conversations about climate change in birth.

Current conversation about birth talks about what is happening now: maternal morbidity/mortality, infant morbidity/mortality, breastfeeding rates à but what about the future?  How will the way we required women to give birth now, impact birthing in the future?

And furthermore, why should we care?

In his book, Childbirth in the Age of Plastics, Michel Odent points out that we just do not know
how interfering in the normal reproductive physiology impacts the future.  We already see an increase in autism and anorexia nervosa.  Could these be caused by a birth intervention, an alteration in the oxytocin system?  Odent says that the evidence points to yes.

What about labor pain?  Either women are fearful of it or they do not want to face it at all.  Regardless, the physiology of labor pain is not being taught in nursing or medical schools and only a handful of childbirth educators and midwives teach about the physiology of labor pain.  Hence, we are raising several generations of both parents and professionals who do not understand that labor pains are a guide for how the laboring mother’s body needs to respond to the labor.  The pains tell the mother how and when to move to assist with the Cardinal Movements.  Labor pain is unlike any other pain humans experience and should not be treated in the drive-thru method of getting rid of it.  It should be considered, contemplated and cooperated with.

During labor, mothers have restricted movement (inhibiting Cardinal Movements), have the pain removed by anesthetic/analgesics (inhibiting Cardinal Movements) and restricted in food and fluids.  Simply put, the medical community, in its zeal to care for laboring women, put those women at a distinct disadvantage and enable fetal and maternal distress to occur.  The medical community promotes the notion that labor and childbirth are emergencies waiting to happen and facilitate the self-fulfilling prophecy.

The aforementioned anesthetics/analgesics cross the fetal blood brain barrier and we are unsure of the results.  Natural pain and coping techniques such as positioning, touch, relaxation, breathing and hydrotherapy are systematically being removed from choice options for pregnant women. Many childbirth education classes minimize or remove exploration of these options due to perceived time constraints (“parents don’t want lengthy classes”), when in reality, parents don’t know what they want and are often disappointed when abbreviated classes are over. And besides, what tools can they use between onset of labor and getting “their” epidural?

Women are not encouraged and often miss out on falling in love with their babies during pregnancy.  They then miss out on the right of passage called labor with the glorious hormonal dance. 

Do we really want assembly line childbirth in the future?  And at what cost?

Odent,M. (2011) Childbirth In The Age of Plastics, Pinter & Martin LTD.

Wednesday, July 09, 2014

CDC Releases US Breastfeeding Report Card

As part of the CDC, the Division of Nutrition, Physical Activity and Obesity released the 2013 Breastfeeding Report Card.

Beginning breastfeeding is at an all time high of 77% with an increase in skin-to-skin and rooming in playing key roles.  Yet not everyone rooms in or has skin-to-skin policies at their hospital:

Top five states with the highest beginning breastfeeding rates include Washington (87.9%), New Hampshire (88.5%), Idaho (91.8%), Colorado (89.1%) and California (91.6%).  Top five states with exclusive breastfeeding at six months include South Dakota (26.3%), Alaska (26.8%), California (27.4%), Idaho (27%) and Wyoming and New Hampshire tied at (24.9%).

States with the highest skin-to-skin were Maine (77.8%), California (79.6%), Oregon (77.4%), Vermont (90%) and Alaska (70%); rooming-in states were Alaska (95%), Washington (83.8%), California (72.6%), Idaho (70.4%) and New Mexico (69.2%).

We are improving but we still have a long way to go!  With Breastfeeding Week within site, let's push for better education and support to mothers for breastfeeding!

View the entire Report Card here.

Monday, June 30, 2014

World Breastfeeding Week ~ Just one month away

The World Alliance for Breastfeeding Action (WABA) has announced the theme for the 2014 World Breastfeeding Week!  Breastfeeding: A Winning Goal - for Life!

World Breastfeeding Week is August 1-7, 2014.

Like the US Healthy People 2020 goals, the Millennium Development Goals blend with the objectives of World Breastfeeding Week:

1. To provide information about the Millennium Development Goals (MDGs) and how they relate to breastfeeding and infant and young child feeding (IYCF).  

2. To showcase the progress made so far in the key gaps in breastfeeding and IYCF.

3. To call attention to the importance of stepping up actions to protect, promote and support breastfeeding as a key intervention in the MDGs and in the post 2015 era.

4. To stimulate interest among young people of both genders to see the relevance of breastfeeding in today's changing world.

Below is an infographic that reviews how the UN's Scientific Committee on Nutrition illustrates how breastfeeding is linked to each of the MDGs.

Watch the World Breastfeeding Week website at for more downloads and to order or purchase more materials for your promotion of World Breastfeeding Week 2014!

Check out The Virtual Breastfeeding Culture by Lara Audelo and Praeclarus Press!

Wednesday, June 25, 2014

US State Legislation on Breastfeeding in Public ~ It's all about perspective

It is all about perspective, right?

Take for example, the new law in the State of Michigan.  Governor Rick Snyder, who’s motto is “Reinventing Michigan: Getting it Right.  Getting it Done.” certainly got it right when it comes to
women breastfeeding in public.

Or is it that babies have the right to eat in public?

Or is it that public breastfeeding isn’t a crime?

Snyder said in a statement this week: “It’s no mystery that the American Academy of Pediatrics said it’s (breastmilk) the ultimate source of nutrition for infants.  And Michigan’s federal target numbers have not been where they need to bel.  The hope is with a bill like this, the numbers will climb.”

But it’s not only legislation that will increase breastfeeding rates.  We must look at several factors including the media.  Recently, the Florida Times-Union wrote a piece on “One of the Most Important Decisions When You’re Having A Baby” and linked the decision to breastfeed with choosing décor for the nursery or what type of diapers to purchase.

An excerpt from Michigan’s online news service, Mlive, stated:

Forty-five states already have some form of law allowing women to breastfeed a child in public or private locations, according to the National Conference on State Legislatures. Another 29 states exempt breastfeeding from public indecency laws.

"There's nothing more natural than giving birth and there's nothing more natural than feeding your child using your body," Shannon Polk, executive director of the Michigan Breastfeeding Network, said during an afternoon press conference in Lansing.

"You wouldn't eat your lunch in a bathroom. Why should our most precious and sweetest citizens have to eat in a bathroom?"

Health experts say that normalizing breastfeeding will benefit babies in Michigan, which ranks in the bottom third of states for breastfeeding rates.

Breastfeeding provides optimal nourishment for children, shields them from infections and helps fight obesity, according to Dr. Matthew Davis, the state's chief medical executive for the Department of Community Health.

And perhaps I am mincing words, but why do women have to be allowed to breastfeed a child in public? If it is a normal bodily function for the mother/baby dyad, it must be all about perspective.

Good for Michigan and good for the other forty-six states that have a law protecting breastfeeding.

Now when are the other four going to step up?

From the National Conference of State Legislatures:

State Breastfeeding Laws

Forty-six states, the District of Columbia and the Virgin Islands have laws that specifically allow women to breastfeed in any public or private location. (Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Washington, West Virginia, Wisconsin and Wyoming.)

Twenty-nine states, the District of Columbia and the Virgin Islands exempt breastfeeding from public indecency laws. (Alaska, Arizona, Arkansas, Florida, Illinois, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New York, North Carolina, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Virginia, Washington, Wisconsin and Wyoming.)

Twenty-five states, the District of Columbia and Puerto Rico have laws related to breastfeeding in the workplace. (Arkansas, California, Colorado, Connecticut, Georgia, Hawaii, Illinois, Indiana, Louisiana, Maine, Minnesota, Mississippi, Montana, New Mexico, New York, North Dakota, Oklahoma, Oregon, Rhode Island, Tennessee, Texas, Vermont, Virginia, Washington and Wyoming.)

Sixteen states and Puerto Rico exempt breastfeeding mothers from jury duty or allow jury service to be postponed. (California, Connecticut, Idaho, Illinois, Iowa, Kansas, Kentucky, Michigan, Mississippi, Missouri, Montana, Nebraska, Oklahoma, Oregon, South Dakota and Virginia.)

Five states and Puerto Rico have implemented or encouraged the development of a breastfeeding awareness education campaign. (California, Illinois, Minnesota, Missouri and Vermont.)

Several states have unique laws related to breastfeeding. For instance,
Virginia allows women to breastfeed on any land or property owned by the state. Puerto Rico requires shopping malls, airports, public service government centers and other select locations to have accessible areas designed for breastfeeding and diaper changing that are not bathrooms. Louisiana's law requires state building to provide suitable areas for breastfeeding and lactation.

At least three states have laws related to child care facilities and breastfeeding. Louisiana prohibits any child care facility from discriminating against breastfed babies. Mississippi requires licensed child care facilities to provide breastfeeding mothers with a sanitary place that is not a toilet stall to breastfeed their children or express milk, to provide a refrigerator to store expressed milk, to train staff in the safe and proper storage and handling of human milk, and to display breastfeeding promotion information to the clients of the facility.Maryland requires child care centers to promote proper nutrition and developmentally appropriate practices by establishing training and policies promoting breastfeeding.

Maryland exempts the sale of tangible personal property that is manufactured for the purpose of initiating, supporting or sustaining breastfeeding from the sales and use tax. Louisiana prohibits state sales or use tax from being applied to any consumer purchases of breastfeeding items.

CaliforniaNew York and Texas have laws related to the procurement, processing, distribution or use of human milk.

New York created a Breastfeeding Mothers Bill of Rights, which is required to be posted in maternal health care facilities. New York also created a law that allows a child under one year of age to accompany the mother to a correctional facility if the mother is breastfeeding at the time she is committed.

Thursday, June 12, 2014

Great New Guidebook for Promoting and Practicing Physiologic Labor/Birth

Supporting a Physiologic Approach to Pregnancy and Birth: A Practical Guide 
Edited by Melissa D. Avery
Paperback $49.99
E-Book $39.99 (Amazon, iBooks, Barnes & Noble)
ISBN: 978-0-470-96286-2
360 pages
June 2013, Wiley-Blackwell

If you need a guidebook or step-by-step guide for transforming any practice to a more more
physiologic approach, this is the first book you need to read.  Supporting a Physiologic Approach to Pregnancy and Birth: A Practical Guide provides an overview of current evidence and a range of practical suggestions to promote physiologic birth within the United States healthcare system. Presenting the latest evidence available on practical approaches and minimal interventions, this book looks into clinic exam rooms and hospital labor units to investigate the possibilities for improving the pregnancy and labor experience. Various contributors discuss recent research and other published information and present a range of ideas, tools, and solutions for maternity care clinicians, including midwives, nurses, physicians, and other members of the perinatal team. 

Topics include interventions for labor and birth, continuous labor support, relaxation and touch therapy for labor, water immersion and water birth, and aromatherapy.  Section 3 provides an organizational approach to supporting physiologic pregnancy and birth which would be beneficial to physician office practices, hospitals, or any health care collaborative.  This section describes changing hospital policy and working quality/maternity care measures.

Supporting a Physiologic Approach to Pregnancy and Birth: A Practical Guide is definitely a book that any maternal/child health professional should have on hand.