Thursday, August 6, 2009

Ignorance abounds

birth at home


The ignorant statements this dr makes is sad.... there is no research to back her stupid thoughts up like babies drowned and how dirty a waterbirth is...

Friday, July 10, 2009

The Big Push

will be in Birmingham. It is a concentrated summit to bring ideas and action to getting midwifery passed as legal in this state.
How to bypass the good ole boys, the religious dogma, the medical misogyny and passive submissiveness of the women in the state. Too often I hear " well my Dr is a Christian so......... In this pause it is a given that ALL is allowed because of a persons religious beliefs. As if being a Christian prevents a dr from EVER emotionally manipulating a woman into giving consent, or that he does not give CS, or episiotomies or inductions unless GOD himself says its ok..... its a copout of being responsible for KNOWING and ACCEPTING how ones birth goes.
Will this Summit help?? I dont know but I think the camaraderie will be nice and a few days with other radical and like minded women WILL be rejuvenating.

Thursday, July 9, 2009

Pit to distress

The "newest" assault being made on laboring women has been outed. Cranking up it until the baby is stressed in order to get that CS the Drs is antsy to do is now being made aware of.
SO how many babies must suffer? or women suffer? before Drs STOP abusing us? Or even further we stop allowing MEN to control out births? When do we as women say..WE HAVE HAD ENOUGH ABUSE!!!!
Check out these sites:
Keyboard Revolution

2006 Article


“Pit to distress” appears on page 182 of the textbook Labor and Delivery Nursing by Michelle Murray and Gayle Huelsmann. In this example, the onus is on the nurse to defend the patient from the doctor if he or she sees the order “pit to distress” by immediately notifying the supervisor or charge nurse."

""Pit to distress was mentioned in the comments of the post My Rant on Pitocin on Knitted in the Womb after the blog’s author, a former chemist and doula, was scolded by an anonymous OB nurse for not understanding the difference between microunits and milliliters when it came to dosing Pitocin.

I’m a trained chemist. I hold a bachelors degree in biochemistry, did some course work towards a masters in chemistry, and worked for 6 years in an R&D lab in the specialty chemicals industry. I probably know WAY more about different units of measure than you do. I used “microunits” and “milliliters” in my discussion appropriately.

I’m not sure why I have to resuscitate a newborn to have “been there,” but since it seems to be very important to you, I’ll talk about it. 90% of the time labor should go just fine, with no need for resuscitation—this according to the World Health Organization. Of the other 10%, not all of them would require newborn resuscitation. If you’ve found that a large percentage of the births you’ve been at have required resuscitation, perhaps you should look at the medical interventions that might be causing that. From my end, the only clients I’ve had who had babies who required resuscitation were cases where there had been “Pit to distress.”

Inductions Not safe or needed??

Indications for induction of labour: a best-evidence review

E Mozurkewich, J Chilimigras, E Koepke, K Keeton, VJ King, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA Correspondence: Dr E Mozurkewich, F4835, PO Box 0264, Mott Hospital, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0264, USA.

Email mozurk@umich.edu

Accepted 2 November 2008. Published Online 4 February 2009.

Background: Rates of labour induction are increasing.

Objectives: To review the evidence supporting indications for induction.

Search strategy: We listed indications for labour induction and then reviewed the evidence. We searched MEDLINE and the Cochrane Library between 1980 and April 2008 using several terms and combinations, including induction of labour, premature rupture of membranes, post-term pregnancy, preterm prelabour rupture of membranes (PROM), multiple gestation, suspected macrosomia, diabetes, gestational diabetes mellitus, cardiac disease, fetal anomalies, systemic lupus erythematosis, oligohydramnios, alloimmunization, rhesus disease, intrahepatic cholestasis of pregnancy (IHCP), and intrauterine growth restriction (IUGR). We performed a review of the literature supporting each indication.

Selection criteria: We identified 1387 abstracts and reviewed 418 full text articles. We preferentially included high-quality systematic reviews or large randomised trials. Where no such studies existed, we included the best evidence available from smaller randomised trials and observational studies.

Main results: We included 34 full text articles. For each indication, we assigned levels of evidence and grades of recommendation based upon the GRADE system. Recommendations for induction of labour for post-term gestation, PROM at term, and premature rupture of membranes near term with pulmonary maturity are supported by the evidence. Induction for IUGR before term reduces intrauterine fetal death, but increases caesarean deliveries and neonatal deaths.

Evidence is insufficient to support induction for women with insulin-requiring diabetes, twin gestation, fetal macrosomia, oligohydramnios, cholestasis of pregnancy, maternal cardiac disease and fetal gastroschisis.

Authors’ conclusions: Research is needed to determine risks and benefits of induction for many commonly advocated clinical indications.

Keywords: Best evidence, indications, induction.

Please cite this paper as: Mozurkewich E, Chilimigras J, Koepke E, Keeton K, King V. Indications for induction of labour: a best-evidence review. BJOG 2009;116:626-636

really? REALLY?????? WOW..im shocked...NOT

From Reuters Health Information
Rates of Severe Obstetric Complications Increased Over Last Decade
www.glorialemay.com/blog

NEW YORK (Reuters Health) Jan 23 - The prevalence of obstetric complications resulting in severe maternal morbidity -- particularly pulmonary embolism and need for blood transfusions -- increased significantly in the US between 1998 and 2005, investigators report in the February issue of Obstetrics and Gynecology.

During the same period, rates of cesarean delivery rose from 21.1% to 31.1%, Dr. Susan F. Meikle, at the National Institutes of Health in Bethesda, Maryland, and co-authors note. The proportion of delivery hospitalizations involving older women and women on Medicaid/Medicare also increased with time, as did deliveries characterized by multiple births, hypertension, and diabetes.

However, they point out, "comprehensive population-based information on severe obstetric complications remains very limited."

To examine trends in severe labor and delivery complications, the authors used data from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project for more than 32 million delivery discharge records.

The proportion of deliveries with at least one severe obstetric complication increased from 0.64% in 1998-1999 to 0.81% in 2004-2005, the report indicates.

There was a 52% increase in pulmonary embolism and a 92% increase in blood transfusions. Rates of renal failure, respiratory distress syndrome, shock, and mechanical ventilation increased by about 20%.

By contrast, rates of severe complications of anesthesia declined, and there were no significant changes in heart failure, puerperal cerebrovascular disorders, pulmonary edema, deep venous thrombosis, disseminated intravascular coagulation, and sepsis.

Adjustment for cesarean delivery explained almost all the increases in estimated risk of renal failure, respiratory distress, and ventilation, although the authors note that their results "do not demonstrate causality."

Dr. Meikle's team points out that the UK has established a surveillance system for rare obstetric complications. Development of a similar system in the US "may improve the ascertainment, monitoring, and classification of these complications and potentially identify modifiable risk factors."

Obstet Gynecol 2009;113:293-299.

Tuesday, June 16, 2009

Delayed cord clamping

We can be kinder

AMA being misogynist once again

AMA has a history of hating women. Especially women who speak out, who say no, who question their godness. And one would think in this enlightened times, AMA would become more aware of its cruelty...but no. White men just dont effin care...

From the ICAN website

AMA Resolution Would Seek to Label “Ungrateful” Patients





Redondo Beach, CA, June 11, 2009 - At the American Medical Association’s (AMA) Annual Meeting next week, delegates will vote on a resolution which proposes to develop CPT (billing) codes to identify and label “non-compliant” patients (1)

The resolution complains:



“The stress of dealing with ungrateful patients is adding to the stress of physicians leading to decreased physician satisfaction.”

“This resolution is alarming in its arrogance and its failure to recognize, or even pay lip service to, patient autonomy,” said Desirre Andrews, the newly elected president of the International Cesarean Awareness Network (ICAN).

If approved, the resolution could hold implications for women receiving maternity care. For pregnant women seeking quality care and good outcomes, “non-compliance” is often their only alternative to accepting sub-standard care. Physicians routinely order interventions like induction, episiotomy, or cesarean section unnecessarily.

Liz Dutzy, a mother from Olathe, Kansas, delivered her first two babies by cesarean and was told by her obstetrician that she needed another surgical delivery. “My doctor told me that I needed to have a cesarean delivery at 39 weeks, or my uterus would rupture and my baby would die.” She sought out another care provider and had a healthy and safe intervention-free {home} birth at 41 weeks and 3 days gestation.

A recent report by Childbirth Connection and The Milbank Memorial Fund, called “Evidence-Based Maternity Care: What It Is and What It Can Achieve ,” (2) shows that the state of maternity care in the U.S. is worrisome, driven largely by a failure of care providers to heed evidence-based care practices. For most women in the U.S., care practices that have been proven to make childbirth easier and safer are underused, and interventions that may increase risks to mothers and babies are routinely overused. The authors of the report point to the “perinatal paradox” of doing more, but accomplishing less.

The resolution proposed by the Michigan delegation of the AMA could threaten patient care and patient autonomy for several reasons:

• Billing codes that would categorize any disagreement and exercise of autonomy on the part of the patient as “non-compliance” “abuse” or “hostility” could create a pathway for insurance companies to deny coverage to patients
• Use of these labels fails to recognize patients as competent partners with physicians in their own care
• Tagging patients as “non-compliant” fails to recognize that there is not a “one size fits all” approach to care, that different opinions among physicians abound, and that patients are entitled to these very same differences of opinion
• Labeling patients as “non-compliant” may, in fact, be punitive, jeopardizing a patient’s ability to seek out other care providers

The resolution also fails to address how it would implicate patients navigating controversial issues in medical care, like vaginal birth after cesarean (VBAC). While a substantive body of medical research demonstrates that VBAC is reasonably safe, if not safer, than repeat cesareans, most physicians and hospitals refuse to support VBAC. (3) The language in the resolution suggests that patients who assert their right to opt for VBAC could be tagged as non-compliant, even though their choice would be consistent with the medical research.

“The reality is that the balance of power in the physician-patient relationship is decidedly tipped towards physicians. The least patients should have is the right to disagree with their doctors and not be labeled a ‘naughty’ patient,” said Andrews.