Birth Matters Virginia

Poorer women less likely to be injured during birth

MSNBC reports that a new government study brought light to some disparities in injuries to women and babies related to childbirth. 

"Women covered by Medicaid were less likely to be injured in childbirth than those with private insurance. Their babies, however, were more likely to experience complications, such as broken collar bones, head injuries and infections.

A similar dichotomy was revealed when the researchers compared births in urban and rural hospitals — moms did better in rural hospitals, while their babies did worse."

So why the differences?

To read the full story, click here.

What really triggers labor?

    An Australian study of 500 women supports the hypothesis that labor is triggered by a hormone - specifically, CRH, or corticotrophin-releasing hormone.  This is a placental hormone that stimulates steroid hormone production in the baby.  Thanks to this study's findings, a prediction of preterm labor may be more accurate using the new information. 

To read the full article, click here.

Mothers of Multiples at Higher Risk for PPD

The American Academy of Pediatrics concluded a study this April that shows mothers of multiples are 43% more likely to have moderate to severe postpartum depression symptoms 9 months after giving birth than mothers of singletons.  The study also revealed that only 27% of  women who had moderate to severe PPD symptoms talked about them with a mental health professional or other physician. 

To read the full abstract of the AAP's findings and methods, click here.

Group Beta Strep test not infallible

       A new study shows that the screening test usually performed on pregnant women at 35-37 weeks for the presence of Group Beta Strep, or GBS, has a higher rate of false negatives than previously thought.  The CDC conducted the first large study of the screening program and is planning a follow-up study to determine what causes the high rate of false negatives. 

     GBS is harmless in most adults, but can cause devastating effects to a newborn who contracts the infection from his or her mother during birth.  It is rare, though, occurring in only one in 3,000 births.  However, when infected, babies can experience blood infections, meningitis, mental retardation, hearing and vision loss, or in the most rare of cases, death. 

     Women who test positive for GBS are given antibiotics during birth, usually penicillin.  For women with allergies, treatments vary, but usually consist of a cocktail of antibiotics.    

     No word yet on what the rate of false positives is.

To read the full story, click here.

Listening to Mothers II Survey and Report

With the release of Childbirth Connection's New Mothers Speak Out study, the findings from the Listening to Mothers II survey are now available without charge.  Topics covered include:

• Planning for pregnancy and pregnancy experience - caregivers, labor inductions, and other interventions, TV shows depicting birth, and more;
• Women's experiences giving birth - breastfedding, physical well-being, mental health, and more;
• Experience with employment and health insurance;
• Choice, control, knowledge and decision making - who should make decisions, knowledge needed for decisions, pressure to have interventions, and more;
• Some important variation - comparisons between women with vaginal birth and cesarean section, first-time and experienced mothers and by race/ethnicity.

To read the full report in PDF format, click here.

For an executive summary of the report, click here.

Why Your "Due Date" Isn't When You May Think It Is!

  The idea that the human gestation period is 10 lunar months originated with a botanist using evidence given in the Bible.   It was then publicized by an obstetrician and has since been accepted as the norm.  So what's wrong with this idea? 

"The folly of Naegele's Rule

The 40 week due date is based upon Naegele's Rule. This theory was originated by Harmanni Boerhaave, a botanist who in 1744 came up with a method of calculating the EDD based upon evidence in the Bible that human gestation lasts approximately 10 lunar months. The formula was publicized around 1812 by German obstetrician Franz Naegele and since has become the accepted norm for calculating the due date. There is one glaring flaw in Naegele's rule. Strictly speaking, a lunar (or synodic - from new moon to new moon) month is actually 29.53 days, which makes 10 lunar months roughly 295 days, a full 15 days longer than the 280 days gestation we've been lead to believe is average. In fact, if left alone, 50-80% of mothers will gestate beyond 40 weeks."

Click here to read the full article in Associated Content. 

Informed Consent and Refusal in Maternity Care Webinar

Friday, June 19, 2009 from 1:00 PM to 2:30 PM EDT

Presented by Holly Goldberg, PhD-c, Tabare Depaep, Esq., and Cordelia Hanna-Cheruiyot, MPH, CHES, CCE, CBA

It’s time to put women back in the driver’s seat when it comes to their maternity care decisions.  CIMS’ experts have examined how current laws and professional practice guidelines affect patient decision-making in maternity care, and demonstrate in this FREE Webinar how patient access to evidence-based research is particularly important during a time when perinatal mortality and morbidity rates, interventions, and disparities are on the rise in the U.S.

Participants will learn:
* The legal and ethical responsibilities that health care professionals have to provide informed consent and refusal
* The components of informed consent and refusal and how to implement them fully during their interactions with patients
* The benefits of informed patient decision making and ways to utilize this knowledge to affect policy change within their institutions.

Need a continuing education certificate?  Processing fees apply: $20 CIMS Members / $25 Non-Members.  Pay online through the CIMS Continuing Education Payment Center at: http://www.motherfriendly.org/webinar.php

This continuing nursing education activity was approved by the Texas Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

Provider approved by the California Board of Registered Nursing, Provider Number 15290, for 1.33 contact hours.

This program is approved by the International Childbirth Education Association (ICEA) for 1 contact hour of continuing education.

Video Contest Finalists!

The finalists are:
Finalists have been announced! The judges will review these and determine who wins the prizes. Deductions are taken from videos that are not in the required time frame (4-7 minutes) or that were submitted late.

Here are the finalists:

Birthing Plain and Simple, by Lynn King (Indiana):
http://www.youtube.com/watch?v=lAre8Ews3fk

Do You Doula? by Julie Clevidence (Ohio):
http://www.youtube.com/watch?v=jvmB96cRnaU

Doulas Make a Difference, by Marla Yeatts (Virginia):
http://www.youtube.com/watch?v=HfOBVPZg94Y

Educated Birth, by Margaret Dombrowski:
http://www.youtube.com/watch?v=uC0UZShzIHw

Home Birth/Water Birth of Judah Darwin, by Rachel Zucker (New York):
http://www.youtube.com/watch?v=quJvDZ_Ev6M&feature=channel_page

Home Birth DIY Labor and Delivery, by Ryanne Hodson (Virginia):
http://www.youtube.com/watch?v=245bDnOVAxQ

It's Worth It, Kat Hickey (Indiana):
http://www.youtube.com/watch?v=AJ7J8BIYa7g

Misconception, Becky Carey (Virginia):
http://www.youtube.com/watch?v=vxRmVciXy-g

Natural Born Babies (Part 1& 2 considered as one entry), Kip Hewitt (California)

:
Part 1: http://www.youtube.com/watch?v=H7DrP4-po5U and
Part 2: http://www.youtube.com/watch?v=DvONLKYfaIA

Prevent Cesarean Surgery, Ragan Cohen (California)

:
http://www.youtube.com/watch?v=EZy0JPtubiQ

The Nature of Natural Birth, Laura Alvarez (Wisconsin):
http://www.youtube.com/watch?v=OrIPtVEjVnc

Weight Gain During Pregnancy

     If you are obese when you begin your pregnancy, guidelines for weight gain have changed dramatically.  Several articles from Time and HealthDay have released the new guidelines, including a video that covers it all.  There are risks for both sides of the coin: gaining too much weight or too little.  Women who do not gain enough weight during pregnancy have higher incidences of stunted fetal growth and preterm delivery.  Women who gain too much have higher occurrences of gestational diabetes and PIH (pregnancy induced hypertension).  In the long run, they also have higher risks of stroke and heart disease.  Their babies also tend to be bigger and born earlier by cesarean.  

   The new guidelines are as follows: 

• Normal-weight women -- those with a BMI of 18.5 to 24.9 -- should gain 25 to 35 pounds during pregnancy;
• Underweight women --those with a BMI less than 18.5 -- should gain 28 to 40 pounds during pregnancy.
• Overweight women should gain 15 to 25 pounds.
• Obese women should gain only 11 to 20 pounds.

A balanced diet is important no matter which category you fall into.  Portion control - knowing what an actual serving of any given food, hydration, and good protein sources are just a few things expectant mothers should consider.  The Brewer Diet is a great place to start if you're unsure what and how to eat while pregnant.  

HR 2358

News from the American Association of Birth Centers!!!

HR 2358 - The Medicaid Birth Center Reimbursement Act

U.S. Reps. Susan Davis (D-CA) and Gus Bilirakis (R-FL) have introduced the Medicaid Birth Center Reimbursement Act to ensure Medicaid birth center facility fee payments to states.     Today, President Obama announced that health care leaders have pledged to save the nation $2 trillion in the next 10 years.  Birth centers are part of the solution to our soaring maternity care costs, and they also provide a safety net for Medicaid women.  This is not the time to be discontinuing payment to facilities that provide safe, cost-effective care for healthy women with Medicaid   All or our work is paying off, however, we still have much to do to pass this legislation.   NEXT STEPS 1) Call your U.S. Representatives and Senators Ask your Representatives to co-sponsor H.R. 2358 The Medicaid Birth Center Reimbursement Act. Ask your Senators to sponsor a Senate Bill Click here for information on How to Contact Your Legislators in 6 Easy Steps.      2) Continue to spread the word/collect signatures for the Consumer Letter We are over half way to our goal of 10,000 signatures by May 31st. Let's keep the momentum going.  Spread the word via email, facebook, put the letter in your waiting rooms, on your websites.  Make our voices heard!   Download the letter to put in your waiting room or anywhere else people gather.   Sign on the letter on the web.   Put a link to the letter on your website: http://www.surveymonkey.com/s.aspx?sm=XGO2ZxaqKojCOGBg_2fBVxWg_3d_3d   3) Continue to collect signatures for the Physician Letter from our friends in the medical community.  Legislators want to know that we have support from physicians.

We need EVERYONE to take action and ensure that our bill is passed as soon as possible!   Sincerely, Jill Alliman, CNM, MSN Chair, Legislative Committee American Association of Birth Centers