"We found that more objective reasons, such as the baby being in a breech position and placenta previa, remained stable over time, while less objective reasons, such as slow progress in labor and concerns about fetal heart tracings contributed large proportions (>50%) to the increasing primary cesarean delivery rate," said Dr. Jessica Illuzzi.
In addition, suspected large infants, twin pregnancies, and preeclampsia contributed to the increase despite relatively stable rates of these conditions in the population during the seven-year study. "This suggests that the use of cesarean for these indications is increasing," said Illuzzi.
Read the full article here
An updated systematic review of the effects of continuous labor support was published in The Cochrane Library in 2011, Issue 2.
This review summarizes results of 21 randomized controlled trials that involved 15,061 women.
Overall, women who received continuous support were less likely than women who did not to:
Women receiving continuous support were more likely than those who did not to:
The reviewers drew the following conclusions about implications for practice:
Continuous support during labour should be the norm, rather than the exception. Policy makers should consider making continuous labor support a covered service, and hospitals should implement programs to offer continuous labor support.
Click here to read more, including the link to the full pdf from Cochrane Library.
"The Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS) released the reportBirths: Preliminary Data for 2009 this morning, which shows that the U.S. cesarean delivery rate rose to a record high of 32.9 percent in 2009. The national cesarean rate, which is up from 32.3% in 2008, has risen for 13 consecutive years, beginning in 1996 when the rate was 20.7%."
Click here to read more and to view graphs of U.S. Childbirth Trends.
Laboring Under an Illusion
The Professional Doulas of Charleston sponsored a showing of the film "Laboring Under an Illusion: Mass Media Childbirth vs. The Real Thing" by Vicki Elson. We hope that you will join us next time!
"In many cultures, birth is still an animal act and the postpartum period an exalted affair. The new mother is revered as the most important being in existence, and the community makes sure she knows it. Her strength is commended, her tenderness protected; her worries and wounds are soothed. She is massaged with sacred oils. She is fed special soups, lovingly prepared by those who have walked the path before her. It does not matter if it is her first baby or her fifth. After each birth, she is pampered and worshipped, an adored queen.
"While true parenthood begins in an instant, with new life’s first breath, the full transition from pregnancy to motherhood takes a little while. Around the world, 40 days seems to be the magic number. That’s 40 days of the mother lying in with the new baby, 40 days of bonding, breastfeeding, and embracing her heightened sense of being. The Latin cultures call it la cuarentena, but it is not an actual quarantine. It is a period of respect for the woman’s metamorphosis."
Click here to read this beautiful essay about the postpartum from Skirt! Magazine.
"Labor induction is significantly associated with a cesarean delivery among nulliparous women (women who have not given birth previously) at term for those with and without medical or obstetric complications. Reducing the use of elective labor induction may lead to decreased rates of cesarean delivery for a population."
Click here to read the abstract from Obstetrics and Gynecology Journal.
"Breast-feeding is in a revival. For years, advocates have worked behind the scenes to bring mothers and babies back to a basic starting point.
"'People are really getting it -- that this is really what makes sense,' said Lin Cook, an advocate on breast-feeding issues and certified lactation consultant. 'Once a woman sits down and breast-feeds her child, then she knows this is the right thing. It's a bonding experience. You can't buy it.'"
Click here to read the entire article from the Charleston Post and Courier.
"Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans, according to guidelines released today by The American College of Obstetricians and Gynecologists.
"The cesarean delivery rate in the US increased dramatically over the past four decades, from 5% in 1970 to over 31% in 2007. Before 1970, the standard practice was to perform a repeat cesarean after a prior cesarean birth. During the 1970s, as women achieved successful VBACs, it became viewed as a reasonable option for some women. Over time, the VBAC rate increased from just over 5% in 1985 to 28% by 1996, but then began a steady decline. By 2006, the VBAC rate fell to 8.5%..."
"Lexington Medical Center was the first in the Southeast to start a doula program. As a doula, Helen has been present at births for 15 years. Remembering her own labor helps her do her job.
"'All these things that I do with them that I wished I had someone to just guide me, show me, this is what's going on with your body. Don't run from it; it's okay,' Helen said. She moves, often without being asked, massaging mom's painful back, moving her into different positions. The movements help get the baby positioned properly..."
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