Thursday, December 31, 2009

The Best and the Worst of 2009

This is a short review of maternal-child health stories of 2009:

One of the top stories of the year was the controversy of the rise in the cesarean rate. Some researchers discount the fact that CDMR (cesarean delivery on maternal request) is not a factor in the rise in the US cesarean rate, while others site fear, and the media preying on those fears AND the fear of litigation with physicians as primary causes of the rise. The CDC said that cesareans triple the neonatal death risk.

In a data brief issued in November of 2009, the CDC also stated that the percentage of late preterm births for which labor was induced more than doubled from 1990 to 2006; the percentage of late preterm births delivered by cesarean also rose markedly. This gave some care providers pause ~ possibly looking at the way they intervened with their clients/patients.

Breastfeeding rates are highly influenced by the amount of medical interventions that occur during labor and birth. The rise in the IV fluid usage rate from such interventions as induction/augmentation or epidural anesthesia is in direct relationship with severe postpartum engorgement. Also, breastfeeding in public got a great deal of press ~ worldwide!

More and more studies are coming about the effects of oxytocin on various conditions including memory, autism and more.

Midwives and their practice became a huge story during 2009 with many states actively examining out of hospital births and the cost effectiveness and safety. The Big Push for Midwives gained even more support in 2009. The mission of The Big Push includes educating the public and policymakers about the reduced costs and improved outcomes associated with out-of-hospital maternity care and Certified Professional Midwives, the maternity care providers trained to provide that service.

Doulas gained another step in the journey toward third party reimbursement for their non-clinical support of laboring mothers and partners in 2009. DONA International issued a statement helping doulas obtain the necessary coding to access insurance reimbursement.
Environmental hazards such as dioxins and their influence on pregnancy health caught the eye of the media in 2009. Bisphenol A exposure (such as that in baby formula bottles) in pregnant mice permanently changes DNA Of offspring. Exposure to phthalates may be a risk factor for low birth weight in infants.
Finally, the H1N1 vaccine controversy was looked upon with some interest for pregnant women and breastfeeding mothers.
It has been a busy year for maternal child health professionals. One that has frustrated some and energized others. For 2010, what are your areas of focus? Your goals?

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