Saturday, September 24, 2011

Cascade of Intervention in Childbirth

Source: Childbirth Connection

What is the "cascade of intervention?"

Many things in life have unintended effects: they may or may not have the effect that we want, and they may also have other unplanned and possibly unwanted effects.

Many maternity care interventions have unintended effects during labor and birth. Often these effects are new problems that are "solved" with further intervention, which may in turn create even more problems. This chain of events has been called the "cascade of intervention."

This chain of events can change the course of a woman's labor in important ways, yet women and their partners are often unaware that many routine interventions can lead to a cascade of unplanned experiences and unwanted side effects.

The maternity practices that can lead to a cascade of intervention include:

  • using various medications to induce labor
  • artificially breaking the membranes surrounding the baby and releasing amniotic fluid before or during labor
  • using synthetic oxytocin to hasten labor
  • giving medications for pain relief
  • using back-lying positions for labor or for birth.

Fear of Childbirth Increases Likelihood of C-Section, Study Suggests

Source: Science Daily

ScienceDaily (Sep. 23, 2011) — A new study published in the international journal Acta Obstetricia et Gynecologica Scandinavica (AOGS) reveals that fear of childbirth is a predisposing factor for emergency and elective cesarean sections, even after psychological counseling. This may mean a negative experience that lasts a lifetime among the approximately 3% of women who in this study were estimated to suffer from excessive fear of childbirth.
Led by Professor Gunilla Sydsjo of the Department of Obstetrics and Gynecology at the University Hospital in Linköping, Central Sweden, researchers analyzed the antenatal and delivery records of 353 women who were referred to a unit for psychosocial obstetrics and gynecology because of fear of childbirth, and 579 women without fear of childbirth.
The researchers found that fear of childbirth affected obstetric outcomes and increased the frequency of emergency and elective cesarean sections. Induction of delivery was more common among the women with fear of childbirth (16.5%) as compared to the women without this problem (9.6%). Women with fear of childbirth who were scheduled for vaginal delivery were more often delivered by emergency cesareans and they also more often requested elective cesarean delivery.
"Maximal effort is necessary to avoid traumatizing deliveries, ensure early recognition of women with traumatic birth experiences, and provide psychological treatment for fear of childbirth," Sydsjo concludes.

Tuesday, September 20, 2011

How Dilated Am I? Assessing Dilation in Labor WITHOUT an Internal Exam.

Source: Sarah Vine

It’s the magic question weighing on most laboring mothers’ minds: (as well as the minds of her partner or birth attendants!) How much longer? Is there any way to tell how far along I am in the birthing process? I’ve seen mothers beg for an internal exam and then be gutted about the answer (What? ONLY 4cm STILL!?) and suddenly *poof* she looses her resolve. It’s akin to having a test and finding out you’ve failed it, in front of your loved ones as well as complete strangers. Everyone knows this feeling is not conducive to labor – suddenly doubt and fear slide in and the laboring mother feels tense. Her oxytocin levels (our body’s natural pain-killer and labor inducer) take a nose dive and immediately she feels much more pain and she starts to run away from the contractions.
Happily, there are a number of external cues that can help you and birth partners get clued in to how much labor is advancing. Some are more subtle than others, but if you are ignoring the clock and keeping focused on staying in tune with your body, you will see them. Listen, embrace, wait.  Enjoy the way it responds! It is amazing what it can do, this body that God gave you.
1. Sound. The way you talk changes from stage to stage in labor. With the first contractions, you can speak during them if you try, or if something surprises you, or if someone says something you strongly disagree with. You may be getting into breathing and moving and ignoring people – but if you really want to you can raise your head and speak in a normal voice. When the contraction disappears you can chat and laugh at people’s jokes and move about getting preparations done. During established labor, There is very little you can do to speak during a contraction. You feel like resting in between, you are not bothered what people are doing around you. As you near transition and birth, you seem to go to ‘another’ level of awareness – it’s almost like a spiritual hideaway. You may share this with someone else, staring into their eyes with each surge, or you may close them and go into yourself. In between surges you stay in this place. It is imperative for birth assistants and partners to stay quiet and support the sanctity of this space: there are no more jokes, and should be as little small talk as possible. Suddenly, the sounds start to change involuntarily: you may have been vocalizing before (moaning, talking and expressing your discomfort, singing, etc) or you may have been silent. Listen – there are deep gutteral sounds along with everything you have heard before, just slipping in there. You are about to start pushing.

Melatonin’s role in labor progress

Source: Birth Faith

In February of last year, I heard about a study that reaffirms what our mammal cousins have known instinctively for thousands of years… birth should happen in a dark, comfortable place. It also helps explain why most women go into labor in the middle of the night. And why so many labors slow down or stall in a hospital setting.

The study’s abstract says this in conclusion: “[Melatonin] synergizes with [oxytocin] to promote [uterine smooth muscle] contractions and to facilitate gap junction activity [in a controlled testing environment]. Such a synergy in [a living human] would promote coordinated and forceful contractions of the late term pregnant uterus necessary for [childbirth]” (Sharkey, Puttaramu, Word and Olcese, “Melatonin Synergizes with Oxytocin to Enhance Contractility of Human Myometrial Smooth Muscle Cells“).
I was absolutely stoked and fascinated when I read this. It makes complete sense! Melatonin is the hormone responsible for inducing sleep. Our bodies increase production of melatonin in darkness, and most humans’ melatonin levels peak in the wee hours of the morning. Daylight and artificial light reduce melatonin production.
In my excited melatonin frenzy, I did some quick internet browsing and discovered thatmeditation increases melatonin production. Some of the most effective coping strategies for labor are akin to meditation–progressive relaxation, hypnobirthing, visualization, breathing techniques–so it makes sense why they’re so helpful.
So… let’s just be logical here… if melatonin and oxytocin synergize to produce labor contractions, wouldn’t it make sense to do everything possible to keep melatonin levels high during childbirth?
And, let’s just be logical again… how well do you think a woman can “meditate” or use coping techniques when she’s…
1) In a sterile, cold, artificially bright, unfamiliar setting?
2) Having an IV inserted, being given forms to sign, or being asked irritating questions about her social security number mid-contraction?
3) Being relentlessly interrupted by hospital staff coming in and out, sticking their fingers inside of her?
Unfortunately, just about everything about a hospital makes it one of the worst possible places to facilitate childbirth progress. If you really want to facilitate the birth process, take a lesson from your pet cat. Turn off the lights! Get to a comfortable place. Do whatever you can to relax and get into a sleep-like meditative state. Let your body do what it already knows how to do. If/When it’s time to leave your dark/comfortable nest, take along some sunglasses and someone who can protect your birthing space from unnecessary distractions and interruptions.  Keep those melatonin levels high!
I love it when science discovers that nature was right all along.

Why Is Average IQ Higher in Some Places?

Source: Scientific American

Being smart is the most expensive thing we do. Not in terms of money, but in a currency that is vital to all living things: energy.  One study found that newborn humans spend close to 90 percent of their calories on building and running their brains. (Even as adults, our brains consume as much as a quarter of our energy.) If, during childhood, when the brain is being built, some unexpected energy cost comes along, the brain will suffer. Infectious disease is a factor that may rob large amounts of energy away from a developing brain. This was our hypothesis, anyway, when my colleagues, Corey Fincher and Randy Thornhill, and I published a paper on the global diversity of human intelligence.
A great deal of research has shown that average IQ varies around the world, both across nations and within them. The cause of this variation has been of great interest to scientists for many years. At the heart of this debate is whether these differences are due to genetics, environment or both.

Breastfeeding is Associated with Improved Child Cognitive Development: A Population-Based Cohort Study

Source: Science Direct 
Maria A. Quigley BA, MScaCorresponding Author Contact InformationE-mail The Corresponding Author, Christine Hockley BAa, Claire Carson BSc, MSc, PhDa, Yvonne Kelly BSc, PhDb, Mary J. Renfrew RGN, SCM, DN, BSc, PhDc, Amanda Sacker BSc, PhDb
aNational Perinatal Epidemiology Unit, University of Oxford, Oxford, United Kingdom
bInstitute for Social and Economic Research, University of Essex, Essex, United Kingdom
cMother and Infant Research Unit, University of York, York, United Kingdom
Received 12 February 2011; revised 31 May 2011; Accepted 23 June 2011. Available online 11 August 2011.


To assess the association between breastfeeding and child cognitive development in term and preterm children.

Study design

We analyzed data on white singleton children from the United Kingdom Millennium Cohort Study. Children were grouped according to breastfeeding duration. Results were stratified by gestational age at birth: 37 to 42 weeks (term, n = 11 101), and 28 to 36 weeks (preterm, n = 778). British Ability Scales tests were administered at age 5 years (naming vocabulary, pattern construction, and picture similarities subscales).


The mean scores for all subscales increased with breastfeeding duration. After adjusting for confounders, there was a significant difference in mean score between children who were breastfed and children who were never breastfed: in term children, a two-point increase in score for picture similarities (when breastfed ≥4 months) and naming vocabulary (when breastfed ≥6 months); in preterm children, a 4-point increase for naming vocabulary (when breastfed ≥4 months) and picture similarities (when breastfed ≥2 months) and a 6-point increase for pattern construction (when breastfed ≥2 months). These differences suggest that breastfed children will be 1 to 6 months ahead of children who were never breastfed.


In white, singleton children in the United Kingdom, breastfeeding is associated with improved cognitive development, particularly in children born preterm.

Hospital staff quizzed over deaths of women after giving birth

Source: Arab News

JEDDAH: A five-member panel set up by Health Minister Dr. Abdullah Al-Rabeeah is questioning 16 doctors, nurses and technicians at a government maternity and children’s hospital in Jeddah for allegedly causing the deaths of two Saudi women soon after they gave birth.
Relatives of the two women accused the hospital staff of negligence and urged authorities to take action against them. According to informed sources, one woman died because she was prescribed the wrong medicine while the other due to a blood infection.
Hospital authorities had handed over the women’s bodies to their relatives without informing them of the real reasons for their deaths. Foreign doctors involved in the case have been banned from traveling abroad until investigations are completed.
Majed Al-Sulami, husband of one victim, said the death of his wife, who is mother of two girls, has turned his life upside down. “I took her to hospital last month when she had labor pains and doctors told me that she would have a natural delivery. After a few hours they gave me the good news that a baby boy had been born. Half an hour later, they asked me to sign a paper authorizing an emergency surgery to remove her uterus because of internal bleeding,” he said. But her condition went from bad to worse after the operation.

Afro-american and white twins born

Source: BBC
Check out video about twins born white and afro-american

Tuesday, September 6, 2011

Spot the fake smile!

Source: BBC

Test your self taking Spot the fake smile test. Can you say genuine smile from the fake one? Complete the test consisting of 20 guesses and  see your results!

A girl smiling

Most people are surprisingly bad at spotting fake smiles. One possible explanation for this is that it may be easier for people to get along if they don't always know what others are really feeling.
Although fake smiles often look very similar to genuine smiles, they are actually slightly different, because they are brought about by different muscles, which are controlled by different parts of the brain.
Fake smiles can be performed at will, because the brain signals that create them come from the conscious part of the brain and prompt the zygomaticus major muscles in the cheeks to contract. These are the muscles that pull the corners of the mouth outwards.

One World Birth

Would you like to know what the most renewed experts in field of maternity health & services say? Check this!
Source : One World Birth

Welcome to One World Birth

One World Birth is a free video resource about birth issues aimed at professionals, campaigners and parents who want to keep their finger on the pulse of what is happening in birth today.
Our dream is that this project will help inspire individuals all around the world to connect, share ideas and shout for change where change is needed. We want birth experts who are at the front line of current thinking and research to empower parents with their knowledge and wisdom so that they feel confident to make the choices that are right for them and have the birth that they deserve.
One World Birth

Midwives Save Lives - global petition

Source: International Confederations of Midwives

ICM has  has joined forces with our partners White Ribbon Alliance and global campaigning charity Save the Children to call on heads of state around the world to increase midwifery resources for education, recruitment and retention.
Over the past two months we have gathered over 5000 signatures in 76 countries, asking governments to commit to increased investment in midwifery education and employment. Copies of the petition are now being handed over to government leaders to help raise the profile of the life saving role of midwives and to generate as much public and political support as possible, before the United Nations General Assembly. 
Petition handovers around the world
In the UK, ICM President Frances Day-Stirk (right) and representatives from WRA and Save the Children handed the petition over to Minister for Development Stephen O'Brien.
In Uganda the Midwifery Association and WRA representatives met with Parliamentary representatives and secured national commitments to increased investment in midwifery

Why men's ring fingers are longer than their index fingers

Source: Breaking Science News

Biologists at the University of Florida have found a reason why men's ring fingers are generally longer than their index fingers — and why the reverse usually holds true for women.
The finding could help medical professionals understand the origin of behavior and disease, which may be useful for customizing treatments or assessing risks in context with specific medical conditions.
Writing this week in the , developmental biologists Martin Cohn, Ph.D., and Zhengui Zheng, Ph.D., of the Howard Hughes Medical Institute and the department of molecular genetics and microbiology at the UF College of Medicine, show that male and female digit proportions are determined by the balance of sex hormones during early embryonic development. Differences in how these hormones activate receptors in males and females affect the growth of specific digits.
The discovery provides a genetic explanation for a raft of studies that link finger proportions with traits ranging from sperm counts, aggression, musical ability, sexual orientation and sports prowess, to health problems such as autism, depression, heart attack and breast cancer.

Breastfeeding Protects Against SIDS

Source: Medpage Today
Breastfeeding may substantially reduce the risk of sudden infant death syndrome (SIDS), especially when breast milk is the sole nutritional source, a meta-analysis showed.

Any breastfeeding was associated with an independent 45% reduction in risk of SIDS, Fern R. Hauck, MD, MS, of the University of Virginia School of Medicine in Charlottesville, and colleagues reported in the July issue of Pediatrics
Breastfeeding as the sole source of nutrition for any duration was associated with a 73% reduction in SIDS (summary odds ratio 0.27, 95% confidence interval 0.24 to 0.31).
This advantage adds to the many infant and maternal benefits of breastfeeding, the researchers noted.
"The recommendation to breastfeed infants should be included with other SIDS risk-reduction messages," the researchers recommended in the paper.

"Ideally, breastfeeding should be exclusive (ie, formula should not be given) for at least four to six months and should be continued until the infant is at least 1 year of age," Hauck's group suggested in concordance with American Academy of Pediatrics' guidelines for six months of exclusive breastfeeding and continuation through age 1 year.

Other factors linked in epidemiologic studies to lower risk of SIDS, such as pacifier use and keeping the baby in the same room but not the same bed as the mother, do not necessarily run counter to promoting breastfeeding, they noted.

KIngdom of Saudi Arabia is opening registration for Midwifery Programme

Source: Al Medina
Armed forces hospital in Ryadh , Kingdom of Saudi Arabia is opening registration for Midwifery programme. This programme is the only one of its kind in the Kingdom and started in 2006.
واس - الرياض
ينظم قسم النساء والولادة بمستشفى القوات المسلحة بالرياض (برنامج القبالة) في السابع عشر من ذي القعدة القادم. وأوضح رئيس قسم النساء والولادة في المستشفى العميد طبيب سلطان بن محمد السلطان أن هذا البرنامج بدأ منذ عام 2006م وهو الوحيد على مستوى المملكة، مشيرًا إلى أن الهدف من إقامة هذا البرنامج تقديم الرعاية الصحية الشاملة للأم أثناء فترة الحمل والولادة وما بعد الولادة والتعرف على المضاعفات التي تواجه الأم والطفل أثناء الحمل والولادة وما بعدها ووضع خطط الرعاية الصحية الشاملة (الجسمانية - النفسية - الاجتماعية) وفقًا لاحتياجات الأم والطفل، إضافة لتخريج سعوديات متخصصات ذات كفاءة علمية وسريرية لتغطية النقص العام في هذا التخصص الحيوي.

Monday, September 5, 2011

Global Midwifery Council

Source: Midwifery Today

The birth of the Global Midwifery Council was in June of 2010 at the Home Child/Midwifery Today Conference in Moscow, Russia. It was born to change the paradigm of birth around the world. At international conferences, Midwifery Today has learned enough about midwifery and birth around the world to realize that birth itself is in deep trouble. The Global Midwifery Council (GMC) is an organization born to help make long term changes in how mothers and babies are treated and how midwifery is carried out. We have a mission to stop inappropriate over-medicalization in birth care!

Through international conferences and networking we have learned so many different ways to view and work with birth, such as using rebozo, which we learned from our Mexican sisters. It is necessary to turn from the over-medicalization of birth and return to a more organic, physiologic model. And the time is now.

We have a lot of work to do on many levels. Maternal death is not just a result of disease and malnutrition. I learned from my sister in Haiti recently that it is also caused by harmful cultural habits. Women there routinely douche after birth to “clean out their insides.” There is little clean water in Haiti. Women die from this. They also sit over boiling hot water after birth, often burning their labia. These habits are taught by their “aunties” as necessary, and cultural habits are hard to break.

 Many cultural habits are dangerous to mothers and babies and need to be stopped; some are likely harmless or even work on levels we do not understand yet and should not be changed; others are practices the world’s midwives can put into practice and begin sharing. Discernment is of utmost importance. In Western medical culture we have many dangerous practices, too, such as cutting women open to extract their babies for no reason at all!

Birth belongs to the mother and baby, but we want them both to live! Midwifery has always been God’s design to serve mother and baby, and we are always looking for better ways serve mother and baby in our work at Midwifery Today conferences.

UK 'has too many hospital births'

Source: BBC

Maternity services across the UK need a radical rethink, the Royal College of Obstetricians and Gynaecologists says.
Dr Anthony Falconer: 'We all have a moral responsibility to create the best services we can'

It wants the number of hospital units cut to ensure 24-hour access to care from senior doctors and says more midwife-led units are needed for women with low-risk pregnancies.

The National Childbirth Trust welcomed the report but says the proposals do not go far enough.
NHS managers said maternity care desperately needed to be reorganised.

Top 50 Blogs About Homebirth

Source : Online-Masters-in Nursing
HINT: look for Midwifery in Kuwait, we`ve got listed too!

Bringing new life into the world can be a beautiful, scary, and above all, emotional experience. For those who wish to go through this life-changing event in the comfort of their own home, there is quite a bit of research to do first.  Look no further, because we have gathered together the best 50 blogs about homebirth. Or, if you are a midwife, doula, or have another profession in the childbirth field, check out these blogs to see what your peers have to say. All of these blogs are regularly updated, and many take a unique look at the pros and cons of homebirth. And, best of all, there are lots of cute baby pictures!

Top Five

  1. Bring Birth Home: This blog was created as a way to share beautiful and inspirational homebirth stories. There is also a ton of information here for anyone planning a homebirth.
  2. Dear Baby G: This blog began as a way to document the blogger’s pregnancy and at homebirth. Now that the baby is born, readers can take a look at the successful birth story, and hear how older siblings are adjusting to a new baby in the house.
  3. On Being Blythe: This self-proclaimed shameless mommy blog highlights the wonder of having your child at home. Lovely photos and thoughtful posts about pregnancy and motherhood, combined with a question and answer series about homebirth, make it an invaluable resource.
    • Why We Love It: This blogger shares some gorgeous pictures of her new little bundle of joy.
    • Favorite Post: Week 40 - The bump moves up
  4. Bedhead Birth Blog: Learn about the importance of umbilical cords, how formula compares with breast milk, and how beautiful a homebirth can be with this photographer’s blog. In addition to taking stunning pictures, this blogger is also a doula, so the posts are backed up by lots of birthing experience.
    • Why We Love It: This blogger reminds us that a birth can be a momentous occasion for an older sibling, as well as for the mother.
    • Favorite Post: A Family Affair
  5. Midwife Thinking: As a homebirth midwife, this blogger seeks to encourage women to consider their different birthing options. Expect artwork, birth stories, and lots of detailed, knowledgeable advice.

The Rest of the Best

  • A Midwife’s Muse: This blog takes a close look at many aspects of being a midwife, including assisting with births, and all the paperwork that goes with it. There is also a great post about postnatal care.
  • Bay Area Birth Blog: Though this doula service also offers hospital birth options, there is some great information for those who wish to have a baby in their own home. One of the main themes of this blog is finding empowerment in your pregnancy and labor.
  • Belly Tales: Read about touching birth stories, as well as facts about babies after they are out of the belly. There are also some great links to tons of helpful resources.
  • Birth: realize your inner strength: Learn more about natural childbirth options at this homebirth midwife’s blog. There are also updates about local natural birth classes.
  • Bloom Spokane: This organization hopes to educate parents so they can make informed decisions about their pregnancy and labor options. Among other topics, there are posts about natural childbirth and homebirth, as well as information about upcoming classes and events.
  • Carolyn's blog: Read about birth stories in developing countries, as well as more general facts about being a midwife. This blogger also discusses midwifery education.
  • Charleston Birth Place: This birthing organization expects women to listen to their own bodies and communicate their needs about childbirth. They strive to provide information about the different childbirth options, including homebirth, and they even post some stirring birth videos.
  • Circus Queen: This British blogger recently had a new addition to her family, with a birth that was a combination of at home and in the hospital. Browse the archives for plenty of pregnancy tales, and why she decided to have her baby at home.
  • Citizens for Midwifery: Read about homebirth facts and statistics on this midwife organization’s blog. There are also some fabulous book reviews.
  • Dar a Luz Women’s Care: This midwife helps families keep their homebirths as stress-free as possible. She also informs readers about pregnancy facts, such as whether or not reducing salt intake is necessary.
  • Dirty Diaper Laundry: This blog is not only about what your baby wears. Read about this blogger’s experience with homebirth, as well as some posts on induction and epidurals.
  • Erin Ellis Homebirth Midwife: This midwife and mother writes about the Birth Change movement in the United States. Learn how politics might be involved in determining the risks of homebirth.
  • Feed the Soil: Many topics, not just pregnancy and birth, are covered in this new mother’s blog. Read about her son’s homebirth, complete with lots of adorable baby pictures.
  • Graceful Approach: This blog offers advice about having a well-balanced life. Read a wonderful article on the homebirth of the blogger’s child, as well as some great time-saving recipes for a new mother.
  • Happy and Healthy Mom: This blog offers lots of information about all stages of mothering, not just those who are pregnant. One post gives a very detailed account of a woman who had a first-time homebirth.
  • Hobo mama: An aspiring writer and mother blogs about natural parenting. Read about her recent homebirth, as well as some tips on breastfeeding and how to comfort an older sibling when the new baby arrives.
  • Home Birth in Israel: Based in Israel, this midwife and doula assists with homebirths. Though this is a fairly new blog, there are already some inspiring birth stories and lovely articles about the power of new life.
  • Homebirth: A Midwife Mutiny: Out of Australia, this blogger strives to bring pregnancy and birth out of a hospital setting. In addition to some very informative articles, there are quite a few videos of a variety of different kinds of births.
  • Ilithyia Inspired: After having a successful, unassisted homebirth herself, this blogger has a lot of experience to draw from for her posts. She is also a doula and self-proclaimed birth servant, and offers tons of advice on all aspects of pregnancy, labor, and breastfeeding.
  • Mama Eve: This natural parenting blog gives advice for dealing with all ages of children. Read about homebirth, c-sections, and early childhood education.
  • Midwifery in Kuwait: This blog brings readers all the latest information about midwife services in Kuwait. Read about induced labor, and celebrity homebirths.