Wednesday, January 28, 2009

Joint Policy Statement ~ They Get It!

The Joint Policy Statement on Normal Childbirth, published in the December issue of the Journal of Obsterics & Gynecology Canada is a wake-up call of American birth professionals.

This important document focuses attention on the rising cesarean rate visible over all of North America and the social and cultural changes that have fostered insecurities amongst childbearing women and their ability to give birth to their children. This document is also one of the very first to make the distinction between Normal and Natural childbirth - a distinction muddied by many.

With what must have been countless hours of writing and editing by the Executive and Council of the Society of Obstetricians and Gynaecologists of Canada (SOGC), the Association of Women's Health, Obstetrics and Neonatal Nurses of Canada (AWHONN Canada), the Canadian Association of Midwives (CAM), the College of Family Physicians of Canada (CFPC), and the Society of Rural Physicians of Canada (SRPC), the document goes even farther to present why normal birth matters not only to mothers but also to babies.

The Joint Statement also goes further to explain recommendations that will enhance the success of adoption of such a statement such as national practice guidelines on normal birth, development of interdisciplinary committees to implement standardized unit polices on normal birth, promotion amongst childbirth educators and maternity care providers about the positive focus of normal birth, and collaborative education opportunities on normal childbirth for maternity care providers.

This last statement is so vital here in the US. The inconvenient truth is that careproviders, be they nurses or physicians, only know what they are taught. They may be completely unaware of the tremendous and energetic normal birth movement currently alive and well in the US. They may not have had the opportunity to see "The Business of Being Born", "Orgasmic Birth", or "Pregnant in America". They may not have had the information available in workshops focusing on normal birth; instead are lured away from workshops such as these and ultimately attend workshops on technological interventions. While technological intervention is important, so are the techniques of normal birth as well as the understanding of the long range effects of normal birth on the mother, baby, mother-baby diad, the entire family and society as a whole.

I applaud our Canadian neighbors for their bold statement and wish them well with their list of 6 recommendations.

I challenge all nursing, childbirth, doula, lactation and medical organizations and associations to endorse such a statement.

For until we are ALL on the same page, normal birth will not be normal in the US.

Click to see the complete Joint Policy Statement on Normal Childbirth.

Tuesday, January 20, 2009

Are Inductions Really Necessary?

A recent Scottish study showed that of 17,000 births, 32% had been induced.

They also found that of the 32% who had been induced, 28% "had no good reason, medical or otherwise" for being induced.

In the US, induction can be done for post-term pregnancies: defined as 42 weeks or longer. Between 5% and 10% of pregnancies fall into this category.

With ultrasound technology to assess viability of the placenta, do most inductions in the US then fall into another category other than post-term pregnancy? If so what is that category?

With the static statistics of maternal/infant morbidity and mortality, it is hard to determine why an induction rate of over 15% exists.

Do you know of a study where more information sheds light on the need for higher inductions? Let us know!

Monday, January 12, 2009

Cesareans At 38 Weeks Risks To Baby

In a recent issue of the New England Journal of Medicine (Jan 8, 2009), experts say it is common for women to undergo cesarean deliveries before the baby has reached the appropriate gestational age because of their desire to give birth and because of obstetricians' desires to schedule the procedure at a convenient time. Delaying the procedure until 39 weeks of gestation decreases neonatal morbidity.

Study authors also found, however, that delaying delivery beyond 40 weeks is linked to increased rates of adverse outcomes. Testing for fetal lung maturity can help determine whether the time is appropriate.

A study of nearly 25,000 cesarean deliveries revealed that when compared with the births at 39 weeks, births at 37 and 38 weeks experienced increased risks. "As compared with infants born vaginally, those born by cesarean section are at increased risk for adverse respiratory outcomes, especially when the delivery occurs before the onset of labor," study authors noted.

It is important for doulas, childbirth educators and office nurses to educate expectant mothers about the need to understand the growth and anatomy of the baby's development and respect that growth and development. Generally, for infants, it is best that they stay in growing in the uterus as long as possible. This means that inductions around 36 or 37 weeks need to be assessed for feasibility and the question, "what if the induction fails?" needs to be asked.

What if an induction fails at 36-37 weeks? For most women, a failed induction results in a cesarean section.

It is important here to note that cesareans are life saving surgeries. However, the rate of cesarean delivery in the United States has increased dramatically, from 20.7 percent in 1996 to 31.1 percent in 2006. And this increase has not positively impacted the maternal mortality/morbidity or infant mortality/morbidity. Hence, there is a question as to the validation of the increase.

Thursday, January 08, 2009

FDA Announces US Formula With Melamine

The US Food & Drug Administration has been quietly testing infant formula for both melamine and cyanuric acid, two chemicals that have been responsible for the deaths of 300,000 infants in China.

While the infants in China were subjected to smaller amounts of the chemicals, where are the long terms clinical tests that determine that ANY amounts of plastic resin powder and a cleaning chemical are safe for our babies???????????????

Though melamine is not believed harmful in tiny amounts, higher concentrations produce kidney stones, which can block the ducts that carry urine from the body, and in serious cases can cause kidney failure.

To date, here are the FDA results for detections in U.S.-made formula (for the complete report, click here):

Two samples tested from one can of Mead Johnson's Infant
Formula Powder, Enfamil LIPIL with Iron had cyanuric acid at levels
of 0.412 and 0.31 parts per million;

Three samples tested from one can of Mead Johnson's Infant
Formula Powder, Enfamil LIPIL with Iron had cyanuric acid at levels
of 0.304, 0.406 and 0.248 parts per million;

Three samples tested from one can of Mead Johnson's Infant
Formula Powder, Enfamil LIPIL with Iron had cyanuric acid at levels
of 0.247, 0.245 and 0.249 parts per million;

Two samples from a can of Nestle's Good Start Supreme Infant
Formula with Iron detected melamine at levels of 0.137 and 0.14
parts per million.

Before the contamination was disclosed, federal food regulators had said they were unable to set a safety threshold for melamine in infant formula. After the news reports, however, the agency set a threshold of 1 part per million of melamine in formula, provided a related chemical, including cyanuric acid, is not present. None of the formula has tested above that threshold.

Legal action has been taken against companies that include melamine and cyanuric acid in pet foods. The travesty is that we appear to care more for our pets than our children. As Linda Smith LCCE, IBCLC ( has stated, there is no excuse for any levels of melamine or cyanuric acid in any food ingested by infants.

Well said.

Tuesday, January 06, 2009

Would You....?

Would you spray WD-40 on your barbecue chicken?

Would you put Gorilla Glue on burger?

Would you add tile grout to your baked potato?

Of course not. That would not be tolerated!

Then why, please someone tell me WHY, are we birth professionals accepting as tolerable, levels of melamine in infant formula? Are we only advocates for birth and not for the infant's life after the birth?

People, it is time to speak out! Are you on Facebook? Join the "Zero Tolerance to ANY melamine levels in infant formula" Cause! Spread the news.