A great website

I just found this great website!

Are you using the right type of healthcare provider for your pregnancy? Take this quiz and find out!

http://www.delivermybaby.org/

Shoulder Dystocia

I'm sure most of you have heard of Shoulder Dystocia, but does anyone know much about it, or how it's resolved?

From Wikipedia:

Shoulder dystocia is a specific case of dystocia whereby after the delivery of the head, the anterior shoulder of the infant cannot pass below the pubic symphysis, or requires significant manipulation to pass below the pubic symphysis. It is diagnosed when the shoulders fail to deliver shortly after the fetal head. In shoulder dystocia, it is the chin that presses against the walls of the perineum

So, the most common way I've seen this handled in the hospital is by using the McRoberts Manuver, which just means pulling your knees all the way back to your ears... followed by suprapubic pressure. The technique is effective in about 42% of cases. Although McRoberts maneuver and suprapubic pressure are generally safe, it is possible to cause maternal injury by performing them.

Personally, I would like to see more of the Gaskin maneuver, named after Certified Professional Midwife, Ina May Gaskin, which involves moving the mother to an all fours position with the back arched, widening the pelvic outlet. I partially understand why it isn't... most women in the hospital have an epidural, and most likely it is heavy enough that quickly moving to an all fours position is nearly impossible.

BUT, for those mothers that can assume this position, the results are good.

One study found:

The most significant observations of the study were the negative findings. No still births or neonatal deaths were reported. Not a single infant suffered Erb palsy, either transient or permanent, and no newborns experienced seizures, hemorrhage, hypoxic-ischemic encephalopathy, cerebral palsy, or fractured clavicle. No patients required any tocolytic medication during labor. No vaginal, cervical, or uterine lacerations occurred. No women required transfusions. And no cases of postpartum, ileus or pulmonary embolus were reported. Overall, the maternal complication associated with the use of the “Gaskin Maneuver” was 1.2 percent (one case of postpartum hemorrhage, transfusion not required), and the neonatal complication rate was 4.9 percent. . . None of these patients required any additional maneuvers. . . Not only was the Gaskin Maneuver instrumental in relieving shoulder impact in every instance, it is also a non-invasive procedure requiring only a change of maternal position.” The average time needed to assume the position and complete the delivery was 2-3 minutes, with the longest reported interval being 6 minutes.

Cheap Websites?

This is a completely unrelated post, but...

I'm offering to do basic, but nice websites for a great price!

Prices will range from $50 for a basic website with no more than 5 pages, up to $100 for more complicated designs.

You are responsible for securing your domain name and choosing a hosting plan. I will provide your finished website in a zipped folder, which you can upload to your site.

Samples:

www.wiregrassdoulaservices.com
www.aplacetorenew.com

Just for FUN...

Jill at the Unnecesarean is having a contest! So, just for fun, I thought I'd throw in an entry.

When VBAC, meets CBAC...

VBAC = Vaginal Birth after Cesarean
HBAC = Home Birth after Cesarean
WBAC = Water Birth after Cesarean
CBAC = Cesarean Birth after Cesarean

For every woman there is an end to pregnancy. Yes, even for those women who's OB's told them they really would stay pregnant forever if they didn't do X, Y or Z. It's an exciting time, anxiously awaiting the impending birth of their new baby.

But, for a VBAC mom, the end of a pregnancy can be bittersweet. There is endless preparation, reading, praying, hoping and dreaming of the long awaited birth. Will they be able to accomplish this? Are they really broken?

If it ends in another cesarean, what is left of that mom? Peace? Emptiness? Gratitude? Pain? Just another scar?

The nationwide VBAC success rate is around 20 percent. But, if you look more closely, you will find better odds. A VBAC mom who is under the care of a practitioner who regards VBAC as no riskier than any other delivery and chooses to deliver in a setting that does not consider VBAC women "high risk,", her success rate is more like 75-90 percent.

So, what does a VBAC turned CBAC mom do?
- Recognize, honor and accept the feelings of loss or sadness if they are present.
- Share your story and feelings with other CBAC mom's.
- Above all, love yourself and your baby.
- Get help if you need it.

Unfortunate

Well, this is the newest update in the BIRTH WORLD.

So, here is my 2 cents on the photo....

It's disgusting, and irritating. The fact that they are so out of touch with birth that they can't even spell "doula" or use the correct term for a birth plan shows that they just "decided" to do this and didn't base it on anything, let alone consider the welfare of their patients.

I also would like to know what they plan on doing if one of their patients shows up in labor, and is using The Bradley Method? I'm assuming they have heard of the Emergency Medical Treatment and Active Labor Act.

EMTALA requires hospital emergency departments (EDs) to provide any individual coming to their premises with a medical screening exam (MSE) to determine if an emergency condition or active pregnancy labor is present. If so, the hospital must supply either stabilization prior to transferring the patient or a certification (signed by the physician) that the transfer is appropriate and meets certain conditions.

Are they planning on refusing to accept the woman as a patient and pass them off to some other on call OB?

Honestly, it's GREAT that they have this posted on their wall. Pregnant women know upfront what they are getting themselves into with this practice and can feel free to run the other direction if necessary.

Someone who called the actual office for more information got this:

"I called this clinic and spoke personally to the receptionist, manager, and then doctor. The receptionist and manager were concerned over the fact that I informed them that "doula" was misspelled, and that "birth contracts" were actually birth plans. The doctor was rude and told me that he HATED doulas and didn't care what I thought and didn't care about evidence-based maternity research."

Well, if that isn't a place to end this post, I don't know what is.

Angie's List

Mainstream attention to poor OB decisions, yes.

Myth vs. Reality: Episiotomy

I'm not going to do anything in the way of my own writing, since this basically speaks for itself. You can't always believe your doctor.

Myth: A nice clean cut is better than a jagged tear.

Reality: "Like any surgical procedure, episiotomy carries a number of risks: excessive blood loss, haematoma formation, and infection. . . . There is no evidence . . . that routine episiotomy reduces the risk of severe perineal trauma, improves perineal healing, prevents fetal trauma or reduces the risk of urinary stress incontinence." Sleep, Roberts, and Chalmers 1989

Summary of Significant Points, from Henci Goer's Book, Obstetric Myths vs. Research Realities

>Episiotomies do not prevent tears into or through the anal sphincter or vaginal tears. In fact, deep tears almost never occur in the absence of an episiotomy.

>Even when properly repaired, tears of the anal sphincter may cause chronic problems with coital pain and gas or fecal incontinence later in life. In addition, anal injury predisposes to rectovaginal fistulas.

>If a woman does not have an episiotomy, she is likely to have a small tear, but with rare exceptions the tear will be, at worst, no worse than an episiotomy.

>Episiotomies do not prevent relaxation of the pelvic floor musculature. Therefore, they do not prevent urinary incontinence or improve sexual satisfaction.

>Episiotomies are not easier to repair than tears.

>Episiotomies do not heal better than tears.

>Episiotomies are not less painful than tears. They may cause prolonged problems with pain, especially pain during intercourse.

>Episiotomies do not prevent birth injuries or fetal brain damage.

>Episiotomies increase blood loss.

>As with any other surgical procedure, episiotomies may lead to infection, including fatal infections.

>Epidurals increase the need for episiotomy. They also increase the probability of instrumental delivery. Instrumental delivery increases both the odds of episiotomy and deep tears.

>The lithotomy position increases the need for episiotomy, probably because the perineum is tightly stretched.

>The birth attendant's philosophy, technique, skill, and experience are the major determinants of perineal outcome.

>Some techniques for reducing perineal trauma that have been evaluated and found effective are: prenatal perineal massage, slow delivery of the head, supporting the perineum, keeping the head flexed, delivering the shoulders one at a time, and doing instrumental deliveries without episiotomy. (Others, such as perineal massage during labor or hot compresses have yet to be studied.)

>Independent of specifically contracting the pelvic floor muscles (Kegels), a regular exercise program strengthens the pelvic floor.

Dothan Meeting - Why Midwives?

Join the Wiregrass Birth Network in Dothan for a discussion on the importance of CPM's in the maternal health circle of care providers with Shannon Burdeshaw, ALMA President.

The Alabama Midwives Alliance (ALMA) is the professional midwifery organization for out-of-hospital midwives in Alabama.

ALMA is gearing up for a heck of a year here in Alabama. We are trying to educate a new lobbyist, talking with legislators again and rallying the troops for fundraising initiatives.

ABC and ALMA are working feverishly to legalize Certified Professional Midwifery and increase access to care in YOUR state.

For more information, visit these websites:
www.alabamamidwivesalliance.org
www.alabamabirthcoalition.org

Thursday, October 29, 2009
10:00am - 12:00pm

Episcopal Church of the Nativity
205 Holly Lane
Dothan, Alabama

Contact us at: wiregrassbirthnetwork@gmail.com
Visit us on the web at: www.wiregrassbirthnetwork.webs.com

Ft. Rucker Meeting - Why Midwives?

Join the Wiregrass Birth Network in Ft. Rucker for a discussion on the importance of CPM's in the maternal health circle of care providers with Shannon Burdeshaw, ALMA President.

The Alabama Midwives Alliance (ALMA) is the professional midwifery organization for out-of-hospital midwives in Alabama.

ALMA is gearing up for a heck of a year here in Alabama. We are trying to educate a new lobbyist, talking with legislators again and rallying the troops for fundraising initiatives.

ABC and ALMA are working feverishly to legalize Certified Professional Midwifery and increase access to care in YOUR state.

For more information, visit these websites:
www.alabamamidwivesalliance.org
www.alabamabirthcoalition.org

Tuesday, October 27, 2009
10:00am - 12:00pm
Allen Heights Neighborhood Center, Fort Rucker, AL

Contact us at: wiregrassbirthnetwork@gmail.com
Visit us on the web at: www.wiregrassbirthnetwork.webs.com